Richard Wale
Individual provider Active NPI Physical Therapy Assistant · Albany, LA
NPI 1689068348 · NPPES record last updated Jan 18, 2022
Key facts
- NPI
- 1689068348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- A5108 (LA)
- Practice address
- 19089 Florida Blvd
Albany, LA 70711-3603 - Phone
- (985) 320-5238
- NPI assigned
- Mar 20, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A5108 | LA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 360 Therapy, LLC | Current |
Accepting new patients |
Locations
29644 S Montpelier Rd
#A
Albany, LA 70711
19089 Florida Blvd
Albany, LA 70711
Phone (225) 209-7140
54033 Highway 1062
#B
Loranger, LA 70446
Phone (225) 209-7140
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A5108 | LA | Yes |
Addresses
Primary practice location
19089 Florida Blvd
Albany, LA 70711-3603
Mailing address
PO Box 1536
Albany, LA 70711-1536
Other practice location 1
54033 Highway 1062 Ste B
Loranger, LA 70446-3538
Phone (225) 209-7140
Other providers in Albany, LA
- St Michael Hospice, LLC
- Melissa Fanning Tate
- Kimberly Thai
- Sharmon P Thompson
- Shelbi Vickers
- Ashley Durbin Wells
- Shadinea N Whittington
- Kelsey Williams
- Eileen Willoughby
- Katy Wilson
All providers in Albany, LA · Physical Therapy Assistant in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.