Individual
MR. SIDNEY PAUL BOURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5550 N HIGHWAY 1, LOCKPORT, LA 70374-2000
(985) 532-6800
(985) 532-6813
Mailing address
127 BARRILLEAUX ST, LOCKPORT, LA 70374-2548
(985) 532-7399
(985) 632-3581
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00536
LA
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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