Healthcare Provider Details

I. General information

NPI: 1770934986
Provider Name (Legal Business Name): CYPRESS PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2016
Last Update Date: 09/29/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 BELLE TERRE BLVD SUITE B
LA PLACE LA
70068-1722
US

IV. Provider business mailing address

607 BELLE TERRE BLVD SUITE B
LA PLACE LA
70068-1722
US

V. Phone/Fax

Practice location:
  • Phone: 985-703-0944
  • Fax:
Mailing address:
  • Phone: 985-703-0944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER CANCIENNE
Title or Position: OWNER / PT
Credential: PT
Phone: 985-703-0944