Individual
MR. DEREK GUIDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DP, DPT
Contact information
Practice address
720 BROWNSWITCH RD, SUITE 2, SLIDELL, LA 70458-1262
(985) 641-2866
Mailing address
1921 OAK CREEK RD APT 240, RIVER RIDGE, LA 70123-5871
(985) 641-2866
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
08302
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08302
PHYSICAL THERAPIST LICENSE
LA
Enumeration date
05/25/2012
Last updated
05/25/2012
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