MEDICARE: COMPREHENSIVE PHYSICAL THERAPY, LLC

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

General Provider Information

NPI Number	:	1568081404
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	103 BEAU CHENE BLVD
Second Line	:
City	:	MANDEVILLE
State	:	LA
Zip	:	70471-1787
Country	:	US
Telephone Number	:	985-272-1017
Fax Number	:

Provider Business Practice Location Address
First Line	:	5404 HIGHWAY 22 STE 200
Second Line	:
City	:	MANDEVILLE
State	:	LA
Zip	:	70471-2518
Country	:	US
Telephone Number	:	985-272-1017
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	WILLIAM BEAUDREAU
Credential	:	PT, DPT
Telephone Number	:	970-214-0915

Provider Enumeration Date	:	04/10/2020
Last Update Date	:	11/18/2025

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