Healthcare Provider Details
I. General information
NPI: 1770568669
Provider Name (Legal Business Name): MOREAU PHYSICAL THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/13/2005
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4314 S SHERWOOD FOREST BLVD STE A150
BATON ROUGE LA
70816-4458
US
IV. Provider business mailing address
4314 S SHERWOOD FOREST BLVD STE A150
BATON ROUGE LA
70816-4458
US
V. Phone/Fax
- Phone: 225-654-8208
- Fax: 225-465-8823
- Phone: 225-654-8208
- Fax: 225-465-8823
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XH1200X |
| Taxonomy | Hand Occupational Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CRISTINA
M
FAUCHEUX
Title or Position: VICE PRESIDENT
Credential: PT
Phone: 225-654-8208