Provider Demographics
NPI:1962400820
Name:INZERELLA, LYNN HOCUTT (PT)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:HOCUTT
Last Name:INZERELLA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 GORDON CROCKET DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-5162
Mailing Address - Country:US
Mailing Address - Phone:337-837-7126
Mailing Address - Fax:337-453-4393
Practice Address - Street 1:413 GORDON CROCKET DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-5162
Practice Address - Country:US
Practice Address - Phone:337-837-7126
Practice Address - Fax:337-453-4393
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT00160R225100000X
LA00160R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist