Healthcare Provider Details

I. General information

NPI: 1336347350
Provider Name (Legal Business Name): DUTCHTOWN PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13053 HWY. 73 STE. B
GEISMAR LA
70734-3021
US

IV. Provider business mailing address

13053 HWY. 73 STE. B
GEISMAR LA
70734-3021
US

V. Phone/Fax

Practice location:
  • Phone: 225-744-3631
  • Fax: 225-744-3647
Mailing address:
  • Phone: 225-744-3631
  • Fax: 225-744-3647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. SCOTT MITCHELL LARSON
Title or Position: OWNER
Credential: PT
Phone: 225-756-2722