Provider Demographics
NPI:1356400345
Name:ADVANTAGE THERAPY SERVICES, L.L.C.
Entity type:Organization
Organization Name:ADVANTAGE THERAPY SERVICES, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:T
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:225-677-8400
Mailing Address - Street 1:17709 OLD JEFFERSON HWY STE A
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-3977
Mailing Address - Country:US
Mailing Address - Phone:225-677-8400
Mailing Address - Fax:225-677-8484
Practice Address - Street 1:17709 OLD JEFFERSON HWY STE A
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-3977
Practice Address - Country:US
Practice Address - Phone:225-677-8400
Practice Address - Fax:225-677-8484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA225X00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAG7649OtherBLUE CROSS BLUE SHIELD
LA5CJ65Medicare ID - Type Unspecified