# BAYOU PHYSICAL THERAPY, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043726631
- **Authorized official:** JASON SPOONER DPT (OWNER)
- **Authorized official phone:** (337) 602-8614

## Contact information

- **Practice address:** 4112 LAKE ST STE 600, LAKE CHARLES, LA 70605-4532
- **Practice address phone:** (337) 602-8614
- **Practice address fax:** (225) 282-2890
- **Mailing address:** 4112 LAKE ST STE 600, LAKE CHARLES, LA 70605-4532
- **Mailing address phone:** (337) 602-8614
- **Mailing address fax:** (225) 282-2890

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 12/19/2017
- **Last updated:** 06/03/2024