# GUNTER PHYSICAL THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SCOTT PHYSICAL THERAPY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942582184
- **Authorized official:** PROF. RUSSELL WAYNE GUNTER DPT (OWNER)
- **Authorized official phone:** (337) 504-2396

## Contact information

- **Practice address:** 401 N COLLEGE RD, SUITE 1, LAFAYETTE, LA 70506-4263
- **Practice address phone:** (337) 504-2396
- **Practice address fax:** (337) 504-2884
- **Mailing address:** PO BOX 61651, LAFAYETTE, LA 70596-1651
- **Mailing address phone:** (337) 504-2396
- **Mailing address fax:** (337) 504-2884

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 4809 | LA | Yes |

## Other

- **Enumeration date:** 09/14/2011
- **Last updated:** 09/14/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5CQ69 | MEDICARE PTAN | LA |