| Action Therapy & Wellness Center, Llc | |
|
211 E Worthy Road Bldg Iv Gonzales LA 70737 | |
| (255) 644-7044 | |
| (225) 644-4414 |
| Full Name | Action Therapy & Wellness Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 211 E Worthy Road, Gonzales, Louisiana |
| Authorized Official Name and Position | Bridget Petrie (OWNER) |
| Authorized Official Contact | 2256447044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Action Therapy & Wellness Center, Llc 211 E Worthy Road Bldg Iv Gonzales LA 70737 Ph: (255) 644-7044 | Action Therapy & Wellness Center, Llc 211 E Worthy Road Bldg Iv Gonzales LA 70737 Ph: (255) 644-7044 |
| NPI Number | 1083961577 |
|---|---|
| Provider Enumeration Date | 08/14/2012 |
| Last Update Date | 03/01/2022 |
| Medicare PECOS PAC ID | 4082850623 |
|---|---|
| Medicare Enrollment ID | O20130426000157 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083961577 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Malcolm M Duplantis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285831271 PECOS PAC ID: 6709854482 Enrollment ID: I20040921000239 |
| Provider Name | Jamie S Canova |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760713762 PECOS PAC ID: 7315072337 Enrollment ID: I20100316000793 |
| Provider Name | Suzanne R Ulmer |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1154486231 PECOS PAC ID: 9133381361 Enrollment ID: I20120503000453 |
| Provider Name | Hailey S Leindecker |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518422484 PECOS PAC ID: 9234521907 Enrollment ID: I20220110002203 |
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