Provider Demographics
NPI:1275585895
Name:GUERIN, ANDRE PHILIPPE (PT)
Entity Type:Individual
Prefix:PROF
First Name:ANDRE
Middle Name:PHILIPPE
Last Name:GUERIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 DOUCET RD
Mailing Address - Street 2:SUITE B2
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3403
Mailing Address - Country:US
Mailing Address - Phone:337-991-9972
Mailing Address - Fax:337-991-9974
Practice Address - Street 1:233 DOUCET RD
Practice Address - Street 2:SUITE B2
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3403
Practice Address - Country:US
Practice Address - Phone:337-991-9972
Practice Address - Fax:337-991-9974
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04385225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4B533C557Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER