Provider Demographics
NPI:1700504123
Name:ROUX PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:ROUX PHYSICAL THERAPY LLC
Other - Org Name:ROUX PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:ROUSSEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:225-289-2040
Mailing Address - Street 1:PO BOX 625
Mailing Address - Street 2:
Mailing Address - City:DONALDSONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70346-0625
Mailing Address - Country:US
Mailing Address - Phone:504-919-7373
Mailing Address - Fax:
Practice Address - Street 1:502 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:DONALDSONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70346-3334
Practice Address - Country:US
Practice Address - Phone:504-919-7373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2024-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty