| Eli William Wallace, OT | |
|
400 Polly Ln, Lafayette, LA 70508-4966 | |
| (337) 443-0652 | |
| Not Available |
| Full Name | Eli William Wallace |
|---|---|
| Gender | Male |
| Speciality | Occupational Therapist |
| Location | 400 Polly Ln, Lafayette, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891538070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | OTT.200733 (Louisiana) | Primary |
| Provider Name | Acadian Physical Therapy Services Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1043676554 PECOS PAC ID: 8123311875 Enrollment ID: O20160719000645 |
| Provider Name | Louisiana Physical Therapy Services Of Lafayette, Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1316614217 PECOS PAC ID: 4183012461 Enrollment ID: O20211020000680 |
| Mailing Address | Practice Location Address |
|---|---|
| Eli William Wallace, OT 105 Concerto Crst, Duson, LA 70529-3352 Ph: (337) 258-5264 | Eli William Wallace, OT 400 Polly Ln, Lafayette, LA 70508-4966 Ph: (337) 443-0652 |
Brittany Hull, MOT, LOTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 134 Rena Dr, Lafayette, LA 70503 Phone: 337-304-6040 | |
Miss Ellen Moosa, LOTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 108 Energy Pkwy, Lafayette, LA 70508 Phone: 337-504-4244 Fax: 337-706-7612 | |
Skyllar Burke, MOT, LOTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 132 Demanade Blvd, Lafayette, LA 70503 Phone: 337-534-8978 Fax: 337-284-3040 | |
Acadian Physical Therapy Services, Llc Occupational Therapist Medicare: Medicare Enrolled Practice Location: 400 Polly Ln, Suite 160, Lafayette, LA 70508 Phone: 337-500-1300 Fax: 337-406-8042 | |
Guy B Guidry, OCCUPATIONAL THERAPI Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 353 Doucet Rd, A-2, Lafayette, LA 70503 Phone: 337-945-6174 Fax: 337-216-7787 | |
Jessica Lane Riddle, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 108 Energy Pkwy, Lafayette, LA 70508 Phone: 337-504-4244 | |
Allison Istre Lagasse, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 206 Englewood Dr, Lafayette, LA 70503 Phone: 337-984-6520 |