Organization
HOUMA PHA, LLC
Active
Other names
Houma Thibodaux Spine and Rehabilitation, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAKE E BORDELON D.C. (OWNER)
(985) 873-8586
Entity
Organization
Contact information
Practice address
430 CORPORATE DR, HOUMA, LA 70360-2461
(985) 873-8586
(985) 873-8565
Mailing address
430 CORPORATE DR, HOUMA, LA 70360-2461
(985) 873-8586
(985) 873-8565
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1328
LA
Other
Enumeration date
01/15/2007
Last updated
04/12/2016
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