Lake Physical Therapy, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

LAKE PHYSICAL THERAPY, LLC

Practice address

1709 W Prien Lake Rd
Lake Charles, LA 70601-8360

Phone

(337) 474-5201

Fax

(337) 474-5524

NPI assigned

May 8, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Victor Joseph Varisco, OT

Title

Managing Member

Phone

(337) 993-0993

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Nolan Bruce, PT

  • Physical Therapist
  • Lake Charles, LA
  • NPI 1306895958
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1124077250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 W PRIEN LAKE RD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018360",
            "telephone_number": "337-474-5201",
            "fax_number": "337-474-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 W PRIEN LAKE RD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018360",
            "telephone_number": "337-474-5201",
            "fax_number": "337-474-5524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "VARISCO",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "337-993-0993",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Charles Rheumatology LLC
• Lake Charles Senior Care Clinic LLC
• Lake Charles Sports & Rehab
• Lake Charles Urgent Care
• Lake Charles Urgent Care
• Lake Wellness Center, LLC
• Lakeshore Medic Pharmacy
• Lakeside Optical
• Amanda Deanne Lamb
• Lyela Marie Lambert

• Occupational Therapist in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Occupational Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.