Healthcare Provider Details

I. General information

NPI: 1457124331
Provider Name (Legal Business Name): MOREAU PHYSICAL THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2023
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3129 PERKINS RD
BATON ROUGE LA
70808-2254
US

IV. Provider business mailing address

4324 S SHERWOOD FOREST BLVD STE B170
BATON ROUGE LA
70816-4481
US

V. Phone/Fax

Practice location:
  • Phone: 225-246-2076
  • Fax: 225-246-2998
Mailing address:
  • Phone: 225-654-8208
  • Fax: 225-654-4642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: CRISTINA M FAUCHEUX
Title or Position: VICE PRESIDENT
Credential:
Phone: 225-654-8208