Healthcare Provider Details

I. General information

NPI: 1639770613
Provider Name (Legal Business Name): CONNER LYNN SCHEUERMANN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CONNER LYNN LUSCY PT

II. Dates (important events)

Enumeration Date: 11/05/2020
Last Update Date: 11/05/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19345 SUNSHINE AVE
COVINGTON LA
70433-8834
US

IV. Provider business mailing address

PO BOX 80964
LAFAYETTE LA
70598-0964
US

V. Phone/Fax

Practice location:
  • Phone: 985-809-3940
  • Fax: 985-809-3942
Mailing address:
  • Phone: 337-233-7977
  • Fax: 337-233-7978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10640
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: