Misty Entremont
Physical Therapy Assistant in Prairieville, LA. Individual provider (NPI-1).
NPI number1144691007
StatusActive
Last updated in NPPESOct 16, 2015
Details
- NPI
- 1144691007
- Entity type
- Individual (NPI-1)
- Name
- Misty Entremont
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 16, 2015
- Last updated
- Oct 16, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | A9033R | LA | Yes |
Practice location
18059 Old Reserve DrPrairieville, LA 70769-5547
Phone 979-487-8798
Mailing address
18059 Old Reserve DrPrairieville, LA 70769-5547
Phone 979-487-8798
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