Organization
OUACHITA PHYSICAL THERAPY,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN C GUILBEAU P.T. (OWNER)
(318) 323-3031
Entity
Organization
Contact information
Practice address
1910 STUBBS AVE, MONROE, LA 71201-5730
(318) 323-3031
(318) 323-3040
Mailing address
1138 OLIVER RD, MONROE, LA 71201-5714
(318) 323-3031
(318) 323-3040
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
04764R
LA
261QP2000X
Physical Therapy Clinic/Center
Primary
00999
LA
261QP2000X
Physical Therapy Clinic/Center
06932
LA
261QP2000X
Physical Therapy Clinic/Center
07456
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G3471
BLUE CROSS OF LOUISIANA
LA
Enumeration date
05/11/2006
Last updated
12/14/2022
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