Organization
MINUTE MED-JOHNSTON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRAD ALAN BOUDREAUX MD (OWNER)
(337) 456-3519
Entity
Organization
Contact information
Practice address
2912 JOHNSTON STREET, LAFAYETTE, LA 70503
(337) 456-3519
Mailing address
2912 JOHNSTON STREET, LAFAYETTE, LA 70503
(337) 456-3519
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
08/07/2013
Last updated
08/07/2013
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