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General NPI Number Information
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NPI Number | 1912822479
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Entity Type | Organization
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Legal Business Name | ROOTED MOTION PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 08/12/2026
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Last Update Date | 08/12/2026
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Provider Practice Location Address
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Address Line | 824 RIDGEFIELD RD
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City | THIBODAUX
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State | LA
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Zip | 70301-2726
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Country | US
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Telephone | 225-206-2598
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Fax |
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Provider Business Mailing Address
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Address Line | 427 ROSELLA DR
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City | THIBODAUX
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State | LA
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Zip | 70301-6942
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Country | US
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Telephone | 225-206-2598
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Fax |
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Authorized Official
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Title or Position | OWNER/PT
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Name | MRS. LORI W. MATHERNE
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Credential | PT, DPT
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Telephone | 225-206-2598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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