Individual
FRAN C MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1103 KALISTE SALOOM ROAD, SUITE 104, LAFAYETTE, LA 70508
(337) 289-9129
(337) 289-9131
Mailing address
1103 KALISTE SALOOM ROAD, SUITE 104, LAFAYETTE, LA 70508
(337) 289-9129
(337) 289-9131
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
00589
LA
225100000X
Physical Therapist
Primary
589
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2252789
AETNA HMO
LA
01
—
7500296
AETNA PPO
LA
Enumeration date
01/12/2007
Last updated
05/02/2023
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