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Organization
ALVIN C MOREAU JR LICENSED PHYSICAL THERAPIST DTD 01 15 82
Active
Organization
ALVIN C MOREAU JR LICENSED PHYSICAL THERAPIST DTD 01 15 82
Active
Other names
Moreau Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTINA M FAUCHEUX PT (VICE PRESIDENT)
(225) 654-8208
Entity
Organization
Contact information
Practice address
4845 MAIN ST, SUITE C, ZACHARY, LA 70791-3943
(225) 286-0181
(225) 286-0186
Mailing address
4314 S SHERWOOD FOREST BLVD STE A150, BATON ROUGE, LA 70816-4458
(225) 654-8208
(225) 465-8823
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5C943
MEDICARE
LA
Enumeration date
12/27/2011
Last updated
11/01/2023
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