Organization
BAYOU WELLNESS CENTER, INC.
Active
Parent organization
BAYOU WELLNESS CENTER, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAYOU WELLNESS CENTER, INC.
Authorized official
MISS LINDA MARIE ANDERSON (CEO/OWNER)
(985) 218-9556
Entity
Organization
Contact information
Practice address
27403 HWY 190, SUITE B, LACOMBE, LA 70445-1550
(985) 218-9555
(985) 218-9557
Mailing address
PO BOX 1550, 27403 HWY 190, SUITE B, LACOMBE, LA 70445-1550
(985) 218-9555
(985) 218-9557
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
LA
208100000X
Physical Medicine & Rehabilitation Physician
—
LA
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
—
LA
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21-33306
—
LA
05
—
2133306
—
LA
Enumeration date
03/03/2009
Last updated
04/02/2014
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