Provider Demographics
NPI:1982899951
Name:PHYSICAL THERAPY CLINIC OF CROWLEY
Entity type:Organization
Organization Name:PHYSICAL THERAPY CLINIC OF CROWLEY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCHMID
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:337-783-4790
Mailing Address - Street 1:PO BOX 985
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70527-0985
Mailing Address - Country:US
Mailing Address - Phone:337-783-4790
Mailing Address - Fax:337-783-3947
Practice Address - Street 1:715 N EASTERN AVE
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-3856
Practice Address - Country:US
Practice Address - Phone:337-783-4790
Practice Address - Fax:337-783-3947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA00042225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty