Brignac Physical Therapy, LLC
Organization Active NPI Clinic/Center · Gramercy, LA
NPI 1811049356 · NPPES record last updated Nov 30, 2015
Key facts
- NPI
- 1811049356
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- BRIGNAC PHYSICAL THERAPY, LLC
- Practice address
- 1732 Deroche Circle
Suite B
Gramercy, LA 70052 - Phone
- (225) 869-0389
- Fax
- (225) 869-0271
- NPI assigned
- Jan 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Chantel Brignac, P.T., A.T.C.
- Title
- Physical Therapist / Owner
- Phone
- (225) 869-0389
Practitioners 18
-
Chantel Brignac, P.T., A.T.C.
-
Fara Allen, PLPC
-
Myrna C. Bouchereau, L.P.T.
-
Eileen Becnel Chisholm, PT, OT
-
Karen Frank, P.T.
-
Phyllis Jackson, S.T.
-
Cheryl Jeane, P.T.
-
Kevin John Lalonde, LOTR CHT
-
Marissa F Laurent, P.T.
-
Mary A Lombardino, M.S., CCC-SLP
-
Kyra Lee Moss, LOTR
-
Michelle A Pavich, RPT
-
Ryan Roussel, DPT
-
Dave K Jain, DO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050203000833 | LA | Part B Supplier - Clinic/Group Practice | 6002867330 |
Receives reassigned benefits from 1 practitioner Practice locations: Gramercy, LA |
National Provider Directory
Locations
1732 Deroche Cir
#B
Gramercy, LA 70052
Phone (225) 868-0309
10900 Highway 3125
Ste D
Lutcher, LA 70071
Phone (225) 869-0389
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | LA | Yes |
Addresses
Primary practice location
1732 Deroche Circle
Suite B
Gramercy, LA 70052
Mailing address
1732 Deroche Circle
Suite B
Gramercy, LA 70052
Phone (225) 869-0389
Other names
- Livingston Rehab & Wellness Center
Other providers in Gramercy, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.