# THE PHYSICAL MEDICINE CENTER, INC.

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

## Provider details

- **NPI number:** 1679589915
- **Authorized official:** MR. KIM A THIBODEAUX (ADMINISTRATOR)
- **Authorized official phone:** (337) 233-5230

## Contact information

- **Practice address:** 401 N COLLEGE RD, STE. \#3 & 4, LAFAYETTE, LA 70506-4263
- **Practice address phone:** (337) 233-5230
- **Practice address fax:** (337) 233-5270
- **Mailing address:** PO BOX 62674, LAFAYETTE, LA 70596-2674
- **Mailing address phone:** (337) 233-5230
- **Mailing address fax:** (337) 233-5270

## Taxonomy

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

## Other

- **Enumeration date:** 07/31/2006
- **Last updated:** 05/28/2008