Organization
PATRICK W. BOURQUE, D.C., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK BOURQUE DC (PRESIDENT/CEO)
(225) 744-3902
Entity
Organization
Contact information
Practice address
17487 OLD JEFFERSON HWY, SUITE D, PRAIRIEVILLE, LA 70769-4043
(225) 744-3902
Mailing address
17487 OLD JEFFERSON HWY, SUITE D, PRAIRIEVILLE, LA 70769-4043
(225) 744-3902
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
1108
LA
Other
Enumeration date
08/17/2010
Last updated
08/17/2010
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