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Organization

LAKE PHYSICAL THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VICTOR JOSEPH VARISCO OT (MANAGING MEMBER)
(337) 993-0993
Entity
Organization

Contact information

Practice address
1709 W PRIEN LAKE RD, LAKE CHARLES, LA 70601-8360
(337) 474-5201
(337) 474-5524
Mailing address
1709 W PRIEN LAKE RD, LAKE CHARLES, LA 70601-8360
(337) 474-5201
(337) 474-5524

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
225X00000X
Occupational Therapist
Primary

Other

Enumeration date
05/08/2006
Last updated
09/11/2025
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