MEDICARE: MR. CLAUDE TREMBLAY P.T., D.P.T.

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	225100000X	Physical Therapist	02780	LA

General Provider Information

NPI Number	:	1174674758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CLAUDE TREMBLAY P.T., D.P.T.

Provider Business Mailing Address
First Line	:	228 N LEWIS ST
Second Line	:
City	:	NEW IBERIA
State	:	LA
Zip	:	70563-2841
Country	:	US
Telephone Number	:	337-364-7496
Fax Number	:	337-364-7499

Provider Business Practice Location Address
First Line	:	228 N LEWIS ST
Second Line	:
City	:	NEW IBERIA
State	:	LA
Zip	:	70563-2841
Country	:	US
Telephone Number	:	337-364-7496
Fax Number	:	337-364-7499

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	07/08/2007

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