Northlake Rehab Professionals

NPI #1699744664 in Hammond, Louisiana

Provider Information

NPI Number: 1699744664
Entity Type: Organization
Organization Name: Northlake Rehab Professionals
Primary Specialty: Specialist
Enumeration Date: Mar 14, 2006
Last Updated: Apr 1, 2008

Practice Location

Address: 2101 ROBIN AVE
City: Hammond
State: Louisiana
ZIP Code: 70403-5772
Phone: (985) 345-0033

Authorized Official

Name: DR. RANDOLPH L ROIG, M.D.
Title: OWNER
Phone: (985) 345-0033

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner - Gerontology — Gerontology	363LG0600X
Specialist	174400000X	Primary

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