Provider Demographics
NPI:1548676174
Name:DELUCA GLAHN, CARRIE (DPT)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:DELUCA GLAHN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2033 N HIGHWAY 190 STE 10
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-8985
Mailing Address - Country:US
Mailing Address - Phone:985-792-7700
Mailing Address - Fax:
Practice Address - Street 1:2033 N HIGHWAY 190 STE 10
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-8985
Practice Address - Country:US
Practice Address - Phone:985-590-4549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08394225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist