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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. EARL DOUGLAS BOURGOYNE, BSCPO

Active Sole Proprietor

MR. EARL DOUGLAS BOURGOYNE, BSCPO is a Physical Therapist healthcare provider located in ALBUQUERQUE, New Mexico. NPI 1114937000 is currently active in the NPPES registry. Verify at CMS.

Physical Therapist · ALBUQUERQUE, NM

Registration Details

NPI Number
1114937000
Provider Type
Individual
Gender
Male
NPI Issued
Aug 9, 2006 (19.978409744006 yrs)
Last Updated
Jul 8, 2007
Sole Proprietor
Yes

Practice Information

Address
1501 SAN PEDRO DR SE
ALBUQUERQUE, NM, 871085153
Browse NM providers · Browse ZIP 87108
Phone
5052562756
Primary Specialty
Physical Therapist
225000000X

Other Physical Therapist Providers in ALBUQUERQUE, NM

Name Credential NPI
MARCIA ALLEN BA 1871820977
RYDER DOTY CPOA, CFO, CFTS 1679097117
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.