Provider Demographics
NPI:1174674758
Name:TREMBLAY, CLAUDE (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:CLAUDE
Middle Name:
Last Name:TREMBLAY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 N LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-2841
Mailing Address - Country:US
Mailing Address - Phone:337-364-7496
Mailing Address - Fax:337-364-7499
Practice Address - Street 1:228 N LEWIS ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-2841
Practice Address - Country:US
Practice Address - Phone:337-364-7496
Practice Address - Fax:337-364-7499
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA02780225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4B612C801Medicare ID - Type Unspecified