# PAIN AND PERFORMANCE REHAB, INC.

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

## Provider details

- **NPI number:** 1942625314
- **Authorized official:** DR. DERRICK HINES D.P.T. (OWNER/PRESIDENT)
- **Authorized official phone:** (337) 504-5144

## Contact information

- **Practice address:** 1144 COOLIDGE BLVD, SUITE F, LAFAYETTE, LA 70503-2622
- **Practice address phone:** (337) 504-5144
- **Practice address fax:** (337) 326-4545
- **Mailing address:** 1144 COOLIDGE BLVD, SUITE F, LAFAYETTE, LA 70503-2622
- **Mailing address phone:** (337) 504-5144
- **Mailing address fax:** (337) 326-4545

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 08100 | LA | Yes |

## Other

- **Enumeration date:** 02/21/2014
- **Last updated:** 04/13/2016