Individual
MR. JOHN DANIEL BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, ATC, LAT
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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