# DYNAMIC THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DYNAMIC THERAPY, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1831355155
- **Legal business name:** DYNAMIC THERAPY, LLC
- **Authorized official:** SHERALYN K CALLIHAN-FAVROT PT (PT/OWNER)
- **Authorized official phone:** (225) 749-2065

## Contact information

- **Practice address:** 309 S VAUGHN DRIVE, SUITE F, BRUSLY, LA 70719
- **Practice address phone:** (225) 749-2065
- **Practice address fax:** (225) 749-2427
- **Mailing address:** 309 S VAUGHN DRIVE, SUITE F, BRUSLY, LA 70719
- **Mailing address phone:** (225) 749-2065
- **Mailing address fax:** (225) 749-2427

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 01005 | LA | Yes |

## Other

- **Enumeration date:** 08/06/2008
- **Last updated:** 07/20/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 437370614B | BLUE CROSS BLUE SHIELD | LA |
| 01 | — | G9567 | BLUE CROSS | LA |