Healthcare Provider Details
I. General information
NPI: 1679612329
Provider Name (Legal Business Name): PHYSICAL THERAPY WORKS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
103 WESTMARK BLVD SUITE 4
LAFAYETTE LA
70506-7376
US
IV. Provider business mailing address
103 WESTMARK BLVD SUITE 4
LAFAYETTE LA
70506-7376
US
V. Phone/Fax
- Phone: 337-988-4444
- Fax: 337-988-4478
- Phone: 337-988-4444
- Fax: 337-988-4478
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 305R00000X |
| Taxonomy | Preferred Provider Organization |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
LYNN
DUMOND-DUNBAR
Title or Position: OWNER
Credential: RPT
Phone: 13379884444