Individual
MR. BRIAN JOSEPH BOURDEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3651 CORTEZ RD W, STE 100, BRADENTON, FL 34210-3167
(941) 739-7828
(941) 739-7838
Mailing address
3651 CORTEZ RD W, STE 100, BRADENTON, FL 34210-3167
(941) 739-7828
(941) 739-7838
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT21211
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2288818
AETNA PROVIDER
FL
01
—
Y909J
BCBS PROVIDER
FL
Enumeration date
10/13/2005
Last updated
02/16/2012
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