Healthcare Provider Details

I. General information

NPI: 1396781001
Provider Name (Legal Business Name): KEVIN P TOUCHET MPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 ELTON RD SUITE I
JENNINGS LA
70546-4138
US

IV. Provider business mailing address

1322 ELTON RD SUITE I
JENNINGS LA
70546-4138
US

V. Phone/Fax

Practice location:
  • Phone: 337-616-8099
  • Fax: 337-824-5494
Mailing address:
  • Phone: 337-616-8099
  • Fax: 337-824-5494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT04168
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: