# THIBODAUX PHYSICAL THERAPY LLC

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

## Provider details

- **NPI number:** 1336716844
- **Authorized official:** MR. CRAIG S PATE PT (OWNER)
- **Authorized official phone:** (985) 446-3736

## Contact information

- **Practice address:** 104 E BAYOU RD STE C, THIBODAUX, LA 70301-3036
- **Practice address phone:** (985) 446-3736
- **Practice address fax:** (985) 446-3701
- **Mailing address:** 104 E BAYOU RD STE C, THIBODAUX, LA 70301-3036
- **Mailing address phone:** (985) 446-3736
- **Mailing address fax:** (985) 446-3701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/04/2021
- **Last updated:** 06/04/2021