Provider Demographics
NPI:1003889072
Name:DAIGLE HIMEL DAIGLE PHYSICAL THERAPY CENTER AND REHABILITATION INC
Entity Type:Organization
Organization Name:DAIGLE HIMEL DAIGLE PHYSICAL THERAPY CENTER AND REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HIMEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:985-447-3164
Mailing Address - Street 1:204 ABIGAIL DR
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-6085
Mailing Address - Country:US
Mailing Address - Phone:985-446-0451
Mailing Address - Fax:985-447-5196
Practice Address - Street 1:808 BAYOU LN
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-4906
Practice Address - Country:US
Practice Address - Phone:985-447-3164
Practice Address - Fax:985-447-5196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========OtherTIN