Individual
JOHNATHAN ORY BOUDREAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3219 STERLINGTON RD, MONROE, LA 71203-2519
(318) 387-5388
Mailing address
3219 STERLINGTON RD, MONROE, LA 71203-2519
(318) 387-5388
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1913
LA
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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