NPI 1861919060 · live from the CMS NPI Registry
Advanced Wellness Louisiana LLC
Physical Therapist in Baton Rouge, LA. National Provider Identifier 1861919060, active.
NPI record
| NPI | 1861919060 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Physical Therapist 225100000X |
| Practice location | 9808 Bluebonnet Blvd Ste 201, Baton Rouge, LA 70810 |
| Practice phone | 225-202-6124 |
| Mailing address | 2023 N Woodchase Ct, Baton Rouge, LA 70808 |
| Enumerated | August 28, 2017 |
| Last updated | September 8, 2017 |
| Authorized official | Kristopher Grunewald, Owner/Physical Therapist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Therapist primary | 225100000X | 07612 (LA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.