Healthcare Provider Details

I. General information

NPI: 1447851878
Provider Name (Legal Business Name): GEAUX FIGHT REHABILITATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2020
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 S TYLER ST
COVINGTON LA
70433-2327
US

IV. Provider business mailing address

1131 S TYLER ST
COVINGTON LA
70433-2327
US

V. Phone/Fax

Practice location:
  • Phone: 985-276-4095
  • Fax: 985-333-1668
Mailing address:
  • Phone: 985-276-4095
  • Fax: 985-333-1668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VIRGINIA LYNN CALLAIS
Title or Position: OWNER
Credential: PT
Phone: 985-276-4095