Individual
MR. JOHN DANIEL BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, ATC, LAT
Contact information
Practice address
816 HARDING ST, LAFAYETTE, LA 70503-2320
(337) 232-3111
(337) 232-5400
Mailing address
124 MEADOWBROOK DR, BROUSSARD, LA 70518-4791
(337) 802-5652
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06867
LA
2255A2300X
Athletic Trainer
J00368
LA
Other
Enumeration date
06/27/2006
Last updated
08/06/2013
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