Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 03433R | LA |
N | 2251G0304X | Physical Therapist - Geriatrics | 03433R | LA |
N | 2251N0400X | Physical Therapist - Neurology | 03433R | LA |
N | 2251S0007X | Physical Therapist - Sports | 03433R | LA |
N | 2251X0800X | Physical Therapist - Orthopedic | 03433R | LA |
NPI | 1649697939 |
---|---|
Provider Name | Jennifer Scanio |
First Address | New Orleans, LA 70124-2745 |
Second Address | New Orleans, LA 70124-2745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2014 |
Last Update Date | 25/03/2014 |