Promoting Livelihood and Ability in Youth Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PROMOTING LIVELIHOOD AND ABILITY IN YOUTH PHYSICAL THERAPY LLC

Doing business as

P L a Y Physical Therapy LLC

Practice address

1800 Buckner St
Suite C-200
Shreveport, LA 71101-4440

Phone

(318) 227-9002

Fax

(318) 227-9025

NPI assigned

Dec 13, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Lynette Crain, PTA

Title

Owner

Phone

(318) 227-9002

Specialties & licenses 1

Addresses

Other names 1

• P L A Y PHYSICAL THERAPY LLC Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1386705036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 BUCKNER ST",
            "address_2": "SUITE C-200",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014440",
            "telephone_number": "318-227-9002",
            "fax_number": "318-227-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 BUCKNER ST",
            "address_2": "SUITE C-200",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014440",
            "telephone_number": "318-227-9002",
            "fax_number": "318-227-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMOTING LIVELIHOOD AND ABILITY IN YOUTH PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CRAIN",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-227-9002",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "P L A Y PHYSICAL THERAPY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kaitlin Prosinski, MOT, OTR/L
• John M Provenza, M.D.
• Stephanie Maria Provenzano

• Physical Therapy Clinic/Center in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physical Therapy Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.