Organization
IN HOME REHAB OF LOUISIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARRON BUSH SMITH LOTR (OWNER)
(337) 541-0201
Entity
Organization
Contact information
Practice address
102 RAPHAEL DR, LAFAYETTE, LA 70508-5952
(337) 849-7431
Mailing address
102 RAPHAEL DR, LAFAYETTE, LA 70508-5952
(337) 849-7431
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
12/08/2019
Last updated
12/08/2019
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