Individual
MR. BRYAN CHELETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2335 CHURCH ST, STE G, ZACHARY, LA 70791-2700
(225) 654-8208
(225) 654-4642
Mailing address
2335 CHURCH ST, STE G, ZACHARY, LA 70791-2700
(225) 654-8208
(225) 654-4642
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06657
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022519
—
LA
01
—
4H331C943
MEDICARE
LA
Enumeration date
10/24/2005
Last updated
01/14/2008
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