Provider Demographics
NPI:1962560656
Name:ORTHOPEDIC & SPORTS THERAPY OF WESTBANK INC
Entity type:Organization
Organization Name:ORTHOPEDIC & SPORTS THERAPY OF WESTBANK INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP CLINIC DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:NUSS
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:504-361-9275
Mailing Address - Street 1:1530 LAPALCO BLVD
Mailing Address - Street 2:SUITE 21
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058
Mailing Address - Country:US
Mailing Address - Phone:504-361-9275
Mailing Address - Fax:504-361-9635
Practice Address - Street 1:1530 LAPALCO BLVD
Practice Address - Street 2:SUITE 21
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-5739
Practice Address - Country:US
Practice Address - Phone:504-361-9275
Practice Address - Fax:504-361-9635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5X371OtherMEDICARE PTAN