Provider Demographics
NPI:1164628947
Name:NAQUIN, WILLIAM RAY (MBA,PT,OCS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:RAY
Last Name:NAQUIN
Suffix:
Gender:M
Credentials:MBA,PT,OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 NEW HOPE DR
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-8085
Mailing Address - Country:US
Mailing Address - Phone:985-227-9588
Mailing Address - Fax:
Practice Address - Street 1:804 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:985-447-8442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1011225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist