Individual
MRS. LISA D BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2002 JOHNSON ST, STE. 100, JENNINGS, LA 70546-3646
(337) 824-4547
(337) 824-4548
Mailing address
137 ALEE RD, EUNICE, LA 70535-6732
(337) 824-4547
(337) 824-4548
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04155
LA
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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