Provider Demographics
NPI:1205276078
Name:LANDRY, ROSS THOMAS (DPT)
Entity type:Individual
Prefix:
First Name:ROSS
Middle Name:THOMAS
Last Name:LANDRY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 ODEA ST
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510-4052
Mailing Address - Country:US
Mailing Address - Phone:337-893-3258
Mailing Address - Fax:337-898-0495
Practice Address - Street 1:317 ODEA ST
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-4052
Practice Address - Country:US
Practice Address - Phone:337-893-3258
Practice Address - Fax:337-898-0495
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist