Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Wellness Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (CONTRACT MANAGER)
(985) 493-4907
Entity
Organization
Contact information
Practice address
726 N. ACADIA ROAD, EDUCATION SUITE, THIBODAUX, LA 70301
(985) 493-4004
Mailing address
602 N ACADIA RD, THIBODAUX, LA 70301-4823
(985) 493-4907
(985) 449-2585
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/19/2021
Last updated
09/05/2023
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