MEDICARE: BRENNAN M MCQUISTON PT, DPT

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
1	225100000X	Physical Therapist	CP052601T	DC
2	225100000X	Physical Therapist	10226	LA

General Provider Information

NPI Number	:	1477118008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENNAN M MCQUISTON PT, DPT

Provider Business Mailing Address
First Line	:	13702 COURSEY BLVD STE 10B
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70817-1370
Country	:	US
Telephone Number	:	225-364-3915
Fax Number	:	225-364-3918

Provider Business Practice Location Address
First Line	:	13702 COURSEY BLVD STE 10B
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70817-1370
Country	:	US
Telephone Number	:	225-364-3915
Fax Number	:	225-364-3918

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2019
Last Update Date	:	02/03/2026

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