| Matthew Quinn Ezernack, | |
| 
					4080 Nelson Rd Ste 500, Lake Charles, LA 70605-2440  | |
| (337) 494-7546 | |
| Not Available | 
| Full Name | Matthew Quinn Ezernack | 
|---|---|
| Gender | Male | 
| Speciality | Physical Medicine & Rehabilitation | 
| Location | 4080 Nelson Rd Ste 500, Lake Charles, Louisiana | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1912699547 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | 11530 (Louisiana) | Primary | 
| Entity Name | Thibodeaux Albro & Touchet Therapy Group Llc | 
|---|---|
| Entity Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice | 
| Entity Identifiers | NPI Number: 1104973262 PECOS PAC ID: 7719081801 Enrollment ID: O20070329000354  | 
| Entity Name | Southwest Louisiana Sports And Rehabilitation Center, Llc | 
|---|---|
| Entity Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice | 
| Entity Identifiers | NPI Number: 1841357761 PECOS PAC ID: 5890854434 Enrollment ID: O20081111000513  | 
| Entity Name | Iowa Therapy Group, Llc | 
|---|---|
| Entity Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice | 
| Entity Identifiers | NPI Number: 1578617924 PECOS PAC ID: 9133288772 Enrollment ID: O20081111000542  | 
| Entity Name | Calcasieu Therapy Group Llc | 
|---|---|
| Entity Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice | 
| Entity Identifiers | NPI Number: 1487085320 PECOS PAC ID: 8325270358 Enrollment ID: O20140407000525  | 
| Entity Name | Lake Charles Sports & Rehab | 
|---|---|
| Entity Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice | 
| Entity Identifiers | NPI Number: 1194301317 PECOS PAC ID: 2961802293 Enrollment ID: O20210608003132  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Matthew Quinn Ezernack, 2923 Summer Place Dr, Sulphur, LA 70663-0758 Ph: (337) 309-0925  | Matthew Quinn Ezernack, 4080 Nelson Rd Ste 500, Lake Charles, LA 70605-2440 Ph: (337) 494-7546  | 
Ms. Freddie Ann Regan,  Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 3221 Ryan St, Suite D, Lake Charles, LA 70601 Phone: 337-439-3344 Fax: 337-439-3380  | |
Delaina Darby Guthrie, DPT Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 3221 Ryan St Ste D, Lake Charles, LA 70601 Phone: 337-439-3344 Fax: 337-439-3380  | |
Brandon Soileau, PT, DPT Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 4080 Nelson Rd Ste 500, Lake Charles, LA 70605 Phone: 337-494-7546 Fax: 337-494-7548  | |
Dr. Craig G Morton, M.D. Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 1747 Imperial Blvd, Lake Charles, LA 70605 Phone: 337-721-7236 Fax: 337-721-7295  | |
Cheryl Brockmeier, MPT Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 4190 Gerstner Memorial Dive, Lake Charles, LA 70607 Phone: 337-240-9730  | |
Mrs. Kim B Anderson, PT Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 1717 E Prien Lake Rd, Suite 1, Lake Charles, LA 70601 Phone: 337-478-5880 Fax: 337-478-5879  | |
Lauren Soileau, PT, DPT Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 3601 Gerstner Memorial Blvd, Lake Charles, LA 70607 Phone: 337-475-9500  |