Organization
BAYOU ORTHOTIC AND PROSTHETIC CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH R. BORDELON C.P.O. (PARTNER/CEO)
(504) 833-7339
Entity
Organization
Contact information
Practice address
400 N CAUSEWAY BLVD, METAIRIE, LA 70001-5338
(504) 833-7339
(504) 833-7559
Mailing address
400 N CAUSEWAY BLVD, METAIRIE, LA 70001-5338
(504) 833-7339
(504) 833-7559
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1103284
—
LA
01
—
H6513
BLUE CROSS BLUE SHIELD OF LA
LA
Enumeration date
07/18/2006
Last updated
03/17/2011
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