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General NPI Number Information
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NPI Number | 1760581623
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Entity Type | Individual
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Provider Name | ROBERT JOSEPH GUIDRY JR. PHYSICAL THERAPIST
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Gender | Male
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 02/23/2016
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Provider Practice Location Address
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Address Line | 37427 MILL PARK AVE
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City | GONZALES
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State | LA
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Zip | 70737-6198
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Country | US
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Telephone | 225-241-0122
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Fax |
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Provider Business Mailing Address
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Address Line | 37427 MILL PARK AVE
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City | GONZALES
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State | LA
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Zip | 70737
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Country | US
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Telephone | 225-241-0122
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Fax |
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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 | 04393
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 04393
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License Number State | LA
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