Healthcare Provider Details

I. General information

NPI: 1487085320
Provider Name (Legal Business Name): CALCASIEU THERAPY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2013
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

486 N HIGHWAY 171
MOSS BLUFF LA
70611-5346
US

IV. Provider business mailing address

1322 ELTON RD STE I
JENNINGS LA
70546-4100
US

V. Phone/Fax

Practice location:
  • Phone: 337-217-0997
  • Fax: 337-217-0998
Mailing address:
  • Phone: 337-824-5488
  • Fax: 337-824-5494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. NATALIE WALKER
Title or Position: COO
Credential:
Phone: 337-824-5488