# FYZICAL OF BATON ROUGE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LOUISIANA EAR, NOSE, THROAT AND SINUS, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1255994539
- **Legal business name:** LOUISIANA EAR, NOSE, THROAT AND SINUS, LLC
- **Authorized official:** EDIE TUCKER (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (225) 408-6900

## Contact information

- **Practice address:** 5258 DIJON DR, BATON ROUGE, LA 70808-4311
- **Practice address phone:** (225) 408-6900
- **Practice address fax:** (225) 408-6946
- **Mailing address:** 8080 BLUEBONNET BLVD STE 2222, BATON ROUGE, LA 70810-7828
- **Mailing address phone:** (225) 408-6900
- **Mailing address fax:** (225) 408-6946

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 04/22/2019
- **Last updated:** 04/22/2019