Healthcare Provider Details

I. General information

NPI: 1528660263
Provider Name (Legal Business Name): ALLIE D SCHEXNAYDER PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 11/09/2020
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 PATRIOT ST STE 201
LAFAYETTE LA
70508-6831
US

IV. Provider business mailing address

PO BOX 849
JENNINGS LA
70546-0849
US

V. Phone/Fax

Practice location:
  • Phone: 337-345-1957
  • Fax: 337-345-1959
Mailing address:
  • Phone: 337-824-8287
  • Fax: 337-824-8290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA9111
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: