Provider Demographics
NPI:1770574592
Name:GUIDRY REHABILITATION LLC
Entity type:Organization
Organization Name:GUIDRY REHABILITATION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:GUIDRY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR, CHT
Authorized Official - Phone:337-654-2828
Mailing Address - Street 1:201 WOODLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:BROUSSARD
Mailing Address - State:LA
Mailing Address - Zip Code:70518-3442
Mailing Address - Country:US
Mailing Address - Phone:337-234-7018
Mailing Address - Fax:337-232-3891
Practice Address - Street 1:201 WOODLAND DRIVE
Practice Address - Street 2:
Practice Address - City:BROUSSARD
Practice Address - State:LA
Practice Address - Zip Code:70518-3442
Practice Address - Country:US
Practice Address - Phone:337-234-7018
Practice Address - Fax:337-232-3891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-01
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5C574Medicare PIN
LA4H657C574Medicare PIN
LA3A130C574Medicare PIN