# GLENN D MANCEAUX PT

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

## Provider details

- **NPI number:** 1548472087
- **Authorized official:** GLENN D MANCEAUX P.T. (PHYSICAL THERAPIST)
- **Authorized official phone:** (985) 868-3136

## Contact information

- **Practice address:** 6902 W. MAIN ST, HOUMA, LA 70360
- **Practice address phone:** (985) 868-3136
- **Mailing address:** 200 PENDLETON, HOUMA, LA 70360

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 0334 | LA | Yes |

## Other

- **Enumeration date:** 05/04/2007
- **Last updated:** 08/22/2020