Organization
SYNERGY REHAB MANAGEMENT SOLUTIONS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD RUEBEN BROUSSARD (CONTROLLER)
(337) 310-8500
Entity
Organization
Contact information
Practice address
1015 OBRIE ST, ZWOLLE, LA 71486-2510
(318) 645-6458
(318) 645-6720
Mailing address
1 LAKESHORE DR, SUITE 1900, LAKE CHARLES, LA 70629-0100
(337) 310-8500
(337) 310-8501
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1158876
—
LA
01
—
4376592960
BCBS OF LOUISIANA
LA
Enumeration date
11/13/2006
Last updated
06/13/2008
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