Healthcare Provider Details

I. General information

NPI: 1750330247
Provider Name (Legal Business Name): IBERIA SPORTS AND REHABILITATION, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 OLD JEANERETTE RD
NEW IBERIA LA
70563-5800
US

IV. Provider business mailing address

1307 OLD JEANERETTE RD
NEW IBERIA LA
70563-5800
US

V. Phone/Fax

Practice location:
  • Phone: 337-367-3331
  • Fax: 337-367-6494
Mailing address:
  • Phone: 337-367-3331
  • Fax: 337-367-6494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. CHAD MARTIN ARCENEAUX
Title or Position: MANAGING MEMBER
Credential:
Phone: 337-367-3331