Provider Demographics
NPI:1598246753
Name:ARCENEAUX, BEAU VINCENT (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BEAU
Middle Name:VINCENT
Last Name:ARCENEAUX
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 1:211 E WORTHY ST BLDG IV
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-4232
Mailing Address - Country:US
Mailing Address - Phone:225-644-7044
Mailing Address - Fax:225-644-4414
Practice Address - Street 1:211 E WORTHY ST BLDG IV
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-4232
Practice Address - Country:US
Practice Address - Phone:225-644-7044
Practice Address - Fax:225-644-4414
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09690225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist