| |
16309 Highway 190, Port Barre, LA 70577 | |
(337) 585-3780 | |
(337) 585-3782 |
Full Name | |
---|---|
Type | Facility |
Speciality | Physical Therapist |
Location | 16309 Highway 190, Port Barre, Louisiana |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1487839338 | NPI | - | NPPES |
5C943 | Other | LA | MEDICARE BILLING NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Primary |
225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
Mailing Address | Practice Location Address |
---|---|
4324 S Sherwood Forest Blvd Ste B170, Baton Rouge, LA 70816-4481 Ph: (225) 654-8208 | 16309 Highway 190, Port Barre, LA 70577 Ph: (337) 585-3780 |
Eric Keith Fontenot, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 16309 Highway 190, Port Barre, LA 70577 Phone: 337-585-3780 Fax: 337-585-3782 |