Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samuel Kullen Mancil

Individual provider Physical Therapist · NPI 1679271977

Samuel Kullen Mancil is a Physical Therapist in Private Practice in Lake Charles, Louisiana. Qualified in 2022, 4 years ago. Practices with Moreau Physical Therapy Inc, a 81-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
4
Licensed in
LA
In the registry since
2023
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Practice location Address checks out

208 W McNeese St
Lake Charles, LA 70605-5638
Phone: (337) 824-5488
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 11254 (LA)

Record details

NPI number1679271977
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 16, 2023
Last updated in NPPESFebruary 16, 2023
Certification dateFebruary 16, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Moreau Physical Therapy Inc. — 81 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Lake Charles