Healthcare Provider Details
I. General information
NPI: 1023293099
Provider Name (Legal Business Name): MOREAU PHYSICAL THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/08/2008
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11424 SULLIVAN RD BLDG C, SUITE A
BATON ROUGE LA
70818-3615
US
IV. Provider business mailing address
4324 S SHERWOOD FOREST BLVD STE B170
BATON ROUGE LA
70816-4481
US
V. Phone/Fax
- Phone: 225-267-7021
- Fax: 225-262-1826
- Phone: 225-654-8208
- Fax: 225-654-4642
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
CRISTINA
E
FAUCHEUX
Title or Position: VICE PRESIDENT
Credential: PT
Phone: 225-654-8208