Russell Wayne Gunter, PT

Individual provider Active NPI Physical Therapist · Scott, LA

NPI 1891744199 · NPPES record last updated Sep 5, 2012

Key facts

NPI
1891744199
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
04809 (LA)
Practice address
101 Park West Dr
Suite B
Scott, LA 70583-8902
Phone
(337) 769-1556
Fax
(337) 769-1557
NPI assigned
May 6, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
04809LAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Acadiana Physical Therapy, Inc. Physical Therapist Past
since Jan 1, 2013
Accepting new patients
MTS-LGH Therapy Services LLC Physical Therapist Past Accepting new patients
Gunter Physical Therapy LLC Physical Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 04809 LA Yes

Addresses

Primary practice location

101 Park West Dr
Suite B
Scott, LA 70583-8902

Mailing address

PO Box 61651
Lafayette, LA 70596-1651
Phone (337) 412-6146

Other providers in Scott, LA

All providers in Scott, LA · Physical Therapist in Louisiana

Sources for this page

Verify at the official NPI Registry.