Provider Demographics
NPI:1043499346
Name:STUDIO P3 EUNICE, LLC
Entity Type:Organization
Organization Name:STUDIO P3 EUNICE, LLC
Other - Org Name:TONI GUILLORY, PT
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILLORY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:337-466-3644
Mailing Address - Street 1:250 E. LAUREL AVE.
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535
Mailing Address - Country:US
Mailing Address - Phone:337-466-3644
Mailing Address - Fax:337-419-0540
Practice Address - Street 1:250 E. LAUREL AVE
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535
Practice Address - Country:US
Practice Address - Phone:337-466-3644
Practice Address - Fax:337-419-0540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA01000261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CH13Medicare PIN