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Individual

EDWARD AVERY DOERLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
1220 BERARD ST STE B, BREAUX BRIDGE, LA 70517-4865
(337) 332-6120
(337) 332-5537
Mailing address
2115 DULLES DR, LAFAYETTE, LA 70506-2652
(337) 981-9182
(337) 988-3441

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
08287
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08287
LA PHYSICAL THERAPY ASSOCIATION
LA
Enumeration date
05/10/2012
Last updated
05/10/2012
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