Stephanie Lynn Marceaux, P.T.

Individual provider Active NPI Physical Therapist · Vinton, LA

NPI 1821153016 · NPPES record last updated Aug 10, 2012

Key facts

NPI
1821153016
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT02051 (LA)
Practice address
1329A Horridge St
Vinton, LA 70668-4531
Phone
(337) 589-2626
Fax
(337) 589-2621
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT02051LAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT02051 LA Yes

Addresses

Primary practice location

1329A Horridge St
Vinton, LA 70668-4531

Mailing address

1329A Horridge St
Vinton, LA 70668-4531
Phone (337) 589-2626

Other identifiers

IdentifierTypeStateIssuer
1821153016OtherLAGROUP MEMBER NPI
1316264153OtherLAGROUP NPI
5DT76OtherLAGROUP PTAN
5X761DT76OtherLAGROUP MEMBER PTAN

Other providers in Vinton, LA

All providers in Vinton, LA · Physical Therapist in Louisiana

Sources for this page

Verify at the official NPI Registry.