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Organization
LAKE PHYSICAL THERAPY, LLC
Active
Organization
LAKE PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR JOSEPH VARISCO OT (MANAGING MEMBER)
(337) 993-0993
Entity
Organization
Contact information
Practice address
1709 W PRIEN LAKE RD, LAKE CHARLES, LA 70601-8360
(337) 474-5201
(337) 474-5524
Mailing address
1709 W PRIEN LAKE RD, LAKE CHARLES, LA 70601-8360
(337) 474-5201
(337) 474-5524
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
NULL
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
05/08/2006
Last updated
09/11/2025
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