Provider Demographics
NPI:1205627700
Name:TRENT MATTHEW BRASSEAUX, PT LLC
Entity type:Organization
Organization Name:TRENT MATTHEW BRASSEAUX, PT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:BRASSEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:337-443-9880
Mailing Address - Street 1:431 RENA DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-4351
Mailing Address - Country:US
Mailing Address - Phone:337-443-9880
Mailing Address - Fax:337-443-9881
Practice Address - Street 1:431 RENA DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-4351
Practice Address - Country:US
Practice Address - Phone:337-443-9880
Practice Address - Fax:337-443-9881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty