Provider Demographics
NPI:1801835707
Name:TROXCLAIR, CHERYL A (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:TROXCLAIR
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 TERRACE HWY
Mailing Address - Street 2:
Mailing Address - City:BROUSSARD
Mailing Address - State:LA
Mailing Address - Zip Code:70518-7628
Mailing Address - Country:US
Mailing Address - Phone:337-303-4300
Mailing Address - Fax:
Practice Address - Street 1:709 KALISTE SALOOM RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-4207
Practice Address - Country:US
Practice Address - Phone:337-234-7018
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA01419225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA01419OtherPT LICENSE #
LA01419OtherPT LICENSE #