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Individual

DR. JOSEPH TODD BOUDREAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
411 US HIGHWAY 9, SUITE 1, LANOKA HARBOR, NJ 08734-2818
(609) 971-0101
(609) 971-0109
Mailing address
411 US HIGHWAY 9, SUITE 1, LANOKA HARBOR, NJ 08734-2818
(609) 971-0101
(609) 971-0109

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00657100
NJ
111N00000X
Chiropractor
CH 7984
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
111509WL9
RENERING PROVIDER NUMBER
NJ
Enumeration date
12/28/2006
Last updated
10/08/2007
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