MEDICARE: MOREAU PHYSICAL THERAPY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5C943	OTHER	LA	MEDICARE BILLING NUMBER

General Provider Information

NPI Number	:	1023293099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOREAU PHYSICAL THERAPY INC.

Provider Business Mailing Address
First Line	:	4324 S SHERWOOD FOREST BLVD STE B170
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-4481
Country	:	US
Telephone Number	:	225-654-8208
Fax Number	:	225-654-4642

Provider Business Practice Location Address
First Line	:	11424 SULLIVAN RD
Second Line	:	BLDG C, SUITE A
City	:	BATON ROUGE
State	:	LA
Zip	:	70818-3615
Country	:	US
Telephone Number	:	225-267-7021
Fax Number	:	225-262-1826

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MRS. CRISTINA E FAUCHEUX
Credential	:	PT
Telephone Number	:	225-654-8208

Provider Enumeration Date	:	01/08/2008
Last Update Date	:	03/26/2025

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