Individual
JORDAN BOURQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
110 TIMBERLAND RIDGE BLVD, LAFAYETTE, LA 70507-2743
(817) 881-5750
Mailing address
110 TIMBERLAND RIDGE BLVD, LAFAYETTE, LA 70507-2743
(817) 881-5750
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/23/2014
Last updated
07/15/2022
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