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NPI Code Detail

MEDICARE: MR. GARY ANTHONY GUIDRY OTR, CHT

MEDICARE: MR. GARY ANTHONY GUIDRY OTR, CHT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOTT.Z10772LA
2225XH1200XHand Occupational TherapistOTT.Z10772LA

General Provider Information

NPI Number : 1164421178
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GARY ANTHONY GUIDRY OTR, CHT
Provider Business Mailing Address
First Line : 4314 U S HIGHWAY 167
Second Line :
City : MAURICE
State : LA
Zip : 70555-3707
Country : US
Telephone Number : 337-654-2828
Fax Number :
Provider Business Practice Location Address
First Line : 108 RUE LOUIS XIV
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-5739
Country : US
Telephone Number : 337-235-8007
Fax Number : 337-235-8008
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 04/01/2015

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