Doctor Name: | EDWARD AVERY DOERLE |
NPI Number: | 1881953933 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | 08287 |
Business Practice Address: | 1220 Berard St Ste B Breaux Bridge, LA - 705174865 |
Business Phone Number: | 3373326120 |
Business Fax Number: | 3373325537 |
Mailing Address: | 2115 Dulles Dr, LAFAYETTE |
State: | LA |
Postal Code: | 705062652 |
Phone Number: | 3379819182 |
Fax Number: | 3379883441 |
NPI Enumeration Date: | 05/10/2012 |
NPI Last Update Date: | 05/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 08287 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |