Boudreaux, Brent David

Boudreaux, Brent David is an sole proprietor health care provider with primary practice located at 104 Denette Dr , Duson LA 70529-3750. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Boudreaux, Brent David can be contacted via phone (337) 344-3400.

Contact Information

Primary practice address
104 Denette Dr Duson LA 70529-3750
Phone: (337) 344-3400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X ATH.J00109 Louisiana

Profile Details

NPI number 1548477573
LBN Legal business name Boudreaux, Brent David
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 17th, 2007
Last updated Jan 10th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1548477573 NPPES
Louisiana Other ATH.J00109 LA STATE BOARD OF MEDICAL EXAMINERS
Louisiana Other 069102490 LA STATE BOARD OF MEDICAL EXAMINERS

Popular Providers