| Dustin Paul Fontenot, PT | |
|
2002 Johnson St, Suite 100, Jennings, LA 70546-3640 | |
| (337) 824-4547 | |
| (337) 824-4548 |
| Full Name | Dustin Paul Fontenot |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 2002 Johnson St, Jennings, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609154343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 08026 (Louisiana) | Primary |
| Provider Name | Ignite Therapy Solutions Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1083448773 PECOS PAC ID: 5193252369 Enrollment ID: O20241230001797 |
| Mailing Address | Practice Location Address |
|---|---|
| Dustin Paul Fontenot, PT Po Box 1096, Jennings, LA 70546-1096 Ph: (337) 824-4547 | Dustin Paul Fontenot, PT 2002 Johnson St, Suite 100, Jennings, LA 70546-3640 Ph: (337) 824-4547 |
Sidney C Dartez, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 2002 Johnson St Ste 100, Jennings, LA 70546 Phone: 337-824-4547 | |
Mrs. Claire T Cope, P.T Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2002 Johnson St, Ste. 100, Jennings, LA 70546 Phone: 337-824-4547 Fax: 337-824-4548 | |
Casey D Villanueva, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 2002 Johnson St Ste 100, Jennings, LA 70546 Phone: 337-824-4547 Fax: 337-824-4548 | |
Mrs. Monica L Bass, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2002 Johnson St, Ste. 100, Jennings, LA 70546 Phone: 337-824-4547 Fax: 337-824-4548 | |
Miss Alicia G Pruitt, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2002 Johnson St, Ste. 100, Jennings, LA 70546 Phone: 337-824-4547 Fax: 337-824-4548 | |
Ms. Erin Nicole Raiford, MSPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2002 Johnson St, Ste. 100, Jennings, LA 70546 Phone: 337-824-4547 Fax: 337-824-4548 | |
Mr. Michael Shane Castille, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 2002 Johnson St, Ste. 100, Jennings, LA 70546 Phone: 337-824-4547 Fax: 337-824-4548 |