Organization
JOSEPH B BOUCREE JR INC
Active
Organization
JOSEPH B BOUCREE JR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM RYALS (FRONT OFFICE MANAGER)
(985) 205-3456
Entity
Organization
Contact information
Practice address
1570 LINDBERG DR STE 8, SLIDELL, LA 70458-8084
(985) 205-3456
(985) 288-0047
Mailing address
1570 LINDBERG DR STE 8, SLIDELL, LA 70458-8084
(985) 205-3456
(985) 288-0047
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
020305
LA
Other
Enumeration date
02/03/2012
Last updated
10/12/2015
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