Individual
RYAN JACOB BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1725 W HARRISON ST STE 440, CHICAGO, IL 60612-3836
(312) 563-2454
Mailing address
1725 W HARRISON ST STE 440, CHICAGO, IL 60612-3836
(312) 563-2454
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
Primary
070021877
IL
2251N0400X
Neurology Physical Therapist
PT011641
GA
Other
Enumeration date
08/20/2014
Last updated
03/11/2025
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