Individual
JEAN LOUISE BOURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
6441 JEFFERSON PIKE, FREDERICK, MD 21703-7039
(301) 620-0236
Mailing address
2085 FLORENCE ROAD, MOUNT AIRY, MD 21771
(301) 829-7204
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17142
MD
Other
Enumeration date
08/06/2009
Last updated
03/21/2026
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