Individual
MR. LYLE EVERETT BOARD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
8080 BLUEBONNET BLVD, BATON ROUGE, LA 70810-7827
(225) 408-7990
(225) 408-7989
Mailing address
8080 BLUEBONNET BLVD, BATON ROUGE, LA 70810-7827
(225) 408-7990
(225) 408-7989
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
Primary
J00203
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J00203
STATE LICENSE
LA
Enumeration date
06/04/2006
Last updated
07/08/2007
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