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General NPI Number Information
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NPI Number | 1306146279
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Entity Type | Individual
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Provider Name | LINDSAY BLAIRE TEZENO P.T.
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Gender | Female
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Dates
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Enumeration Date | 10/26/2010
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Last Update Date | 01/04/2011
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Provider Practice Location Address
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Address Line | 2002 JOHNSON ST SUITE 100
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City | JENNINGS
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State | LA
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Zip | 70546-3640
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Country | US
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Telephone | 337-824-4547
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Fax | 337-824-4548
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Provider Business Mailing Address
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Address Line | 138 STONEBURG DR
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City | DUSON
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State | LA
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Zip | 70529-3946
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Country | US
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Telephone | 337-824-4547
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Fax | 337-824-4548
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05043
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License Number State | LA
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