Individual
MRS. TAMARA L BORDELON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1325 LOUISVILLE AVE, MONROE, LA 71201-6021
(318) 807-1500
(318) 807-1504
Mailing address
130 DESIARD ST STE 355, MONROE, LA 71201-7363
(318) 807-7875
(318) 812-6603
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
00718
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104370500
FED EMP W/C
LA
05
—
2387146
—
LA
Enumeration date
08/14/2006
Last updated
06/13/2019
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