Individual
DR. RYAN BOURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1370 E 70TH ST, SHREVEPORT, LA 71105-4924
(318) 670-3318
Mailing address
4903 LAUREL LN, BOSSIER CITY, LA 71111-5407
(985) 637-2851
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1885
LA
Other
Enumeration date
01/28/2022
Last updated
12/12/2023
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