Healthcare Provider Details

I. General information

NPI: 1497686018
Provider Name (Legal Business Name): CASSIDY BREANNE RHEA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1377
WEST MONROE LA
71294-1377
US

IV. Provider business mailing address

107 SUMMER LN
WEST MONROE LA
71291-3501
US

V. Phone/Fax

Practice location:
  • Phone: 318-396-1969
  • Fax: 318-396-2928
Mailing address:
  • Phone: 318-396-1969
  • Fax: 318-396-2928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12323
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: