| Boudreaux Spine & Joint | |
|
309 Goode St Suite 2d Houma LA 70360-4562 | |
| (504) 338-6042 | |
| (985) 447-9578 |
| Full Name | Boudreaux Spine & Joint |
|---|---|
| Speciality | Clinic/Center |
| Location | 309 Goode St, Houma, Louisiana |
| Authorized Official Name and Position | Jonathan James Boudreaux (CHIROPRACTOR) |
| Authorized Official Contact | 5043386042 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boudreaux Spine & Joint 309 Goode St Suite 2d Houma LA 70360-4562 Ph: (504) 338-6042 | Boudreaux Spine & Joint 309 Goode St Suite 2d Houma LA 70360-4562 Ph: (504) 338-6042 |
| NPI Number | 1225356835 |
|---|---|
| Provider Enumeration Date | 05/06/2010 |
| Last Update Date | 05/06/2010 |
| Medicare PECOS PAC ID | 6103958533 |
|---|---|
| Medicare Enrollment ID | O20100720000568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225356835 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 1496 (Louisiana) | Primary |
| Provider Name | Jonathan J Boudreaux |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1649410267 PECOS PAC ID: 5698807030 Enrollment ID: I20100720000709 |
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