Healthcare Provider Details

I. General information

NPI: 1649734385
Provider Name (Legal Business Name): ALEXIS V ZURHEIDE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

726 VETERANS DR
CARENCRO LA
70520-3619
US

IV. Provider business mailing address

105 ALPINE MEADOWS LN
LAFAYETTE LA
70506-6357
US

V. Phone/Fax

Practice location:
  • Phone: 337-565-4355
  • Fax:
Mailing address:
  • Phone: 618-581-2944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11747
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: