Provider Demographics
NPI:1396735825
Name:LAFLEUR, ADAM (PT)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:
Last Name:LAFLEUR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 TIMBER TRAILS RD
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517-6544
Mailing Address - Country:US
Mailing Address - Phone:337-344-0957
Mailing Address - Fax:
Practice Address - Street 1:1032 TIMBER TRAILS RD
Practice Address - Street 2:
Practice Address - City:BREAUX BRIDGE
Practice Address - State:LA
Practice Address - Zip Code:70517-6544
Practice Address - Country:US
Practice Address - Phone:337-344-0957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06409225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1327301Medicaid
LA4C775C943Medicare ID - Type Unspecified