Healthcare Provider Details

I. General information

NPI: 1174438352
Provider Name (Legal Business Name): AUSTIN KIRKPATRICK DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 KALISTE SALOOM RD STE H
LAFAYETTE LA
70508-5760
US

IV. Provider business mailing address

108 RUE LOUIS XIV
LAFAYETTE LA
70508-5739
US

V. Phone/Fax

Practice location:
  • Phone: 337-889-3106
  • Fax: 337-504-7453
Mailing address:
  • Phone: 337-889-3106
  • Fax: 337-504-7453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12495
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: