Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. BRENT DAVID BOUDREAUX, ATC
Active Sole ProprietorMR. BRENT DAVID BOUDREAUX, ATC is a Athletic Trainer healthcare provider located in DUSON, Louisiana. NPI 1548477573 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · DUSON, LA
Registration Details
- NPI Number
- 1548477573
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 17, 2007 (19.208730287828 yrs)
- Last Updated
- Jan 10, 2021
- License
-
ATH.J00109 (LA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
104 DENETTE DRDUSON, LA, 705293750Browse LA providers · Browse ZIP 70529
- Phone
- 3373443400
- Primary Specialty
-
Athletic Trainer
2255A2300X
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.