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NPI Code Detail

MEDICARE: BAILY AMEDEE LANDRY MOT

MEDICARE: BAILY AMEDEE LANDRY MOT
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
1225X00000XOccupational Therapist324054LA

General Provider Information

NPI Number : 1386253037
Entity Type Code : Individual
Provider Name (Legal Business Name) : BAILY AMEDEE LANDRY MOT
Provider Business Mailing Address
First Line : 8080 BLUEBONNET BLVD STE 1000
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-7827
Country : US
Telephone Number : 225-924-2424
Fax Number : 225-408-7980
Provider Business Practice Location Address
First Line : 1014 SAINT CLAIR BLVD STE 1000
Second Line :
City : GONZALES
State : LA
Zip : 70737-5027
Country : US
Telephone Number : 225-215-4437
Fax Number : 225-390-1419
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2020
Last Update Date : 03/22/2023

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Directions to “ BAILY AMEDEE LANDRY MOT” Practice Location

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