Provider Demographics
NPI:1891847190
Name:LEDOUX, RACHEL LYNN (PT, MPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LYNN
Last Name:LEDOUX
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 VANBURG PL
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-1831
Mailing Address - Country:US
Mailing Address - Phone:337-364-6366
Mailing Address - Fax:337-364-6166
Practice Address - Street 1:484 ALBERTSON PKWY STE A
Practice Address - Street 2:
Practice Address - City:BROUSSARD
Practice Address - State:LA
Practice Address - Zip Code:70518-4968
Practice Address - Country:US
Practice Address - Phone:337-839-8883
Practice Address - Fax:337-839-8939
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist