| NPI | 1548472087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN D MANCEAUX Physical Therapist 985-868-3136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 0334) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |