Individual
DR. DANIEL J BOURASSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC PHD
Contact information
Practice address
103 NIGHTINGALE LN, GULF BREEZE, FL 32561-4300
(850) 250-2730
Mailing address
1400 E DE SOTO ST, PENSACOLA, FL 32501-3439
(850) 250-2730
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH 6116
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH0006116
LICENSE FOR FLORIDA
FL
Enumeration date
08/02/2006
Last updated
06/03/2019
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