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NPI Code Detail

MEDICARE: BOULET REHABILITATION SERVICES, INC.

MEDICARE: BOULET REHABILITATION SERVICES, 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
1261QP2000XPhysical Therapy Clinic/CenterPT0678LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437159852
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOULET REHABILITATION SERVICES, INC.
Provider Business Mailing Address
First Line : 119 REPRESENTATIVE ROW
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-3833
Country : US
Telephone Number : 337-264-9856
Fax Number : 337-261-5042
Provider Business Practice Location Address
First Line : 119 REPRESENTATIVE ROW
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-3833
Country : US
Telephone Number : 337-264-9856
Fax Number : 337-261-5042
Authorized Official
Title or Position : PHYSICAL THERAPIST/OWNER
Name : MS. PATRICIA ANN BOULET
Credential : P.T.
Telephone Number : 337-264-9856
Provider Enumeration Date : 07/28/2005
Last Update Date : 10/30/2007

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Directions to “BOULET REHABILITATION SERVICES, INC. ” Practice Location

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