Boudreaux, Bryan Gerard

Boudreaux, Bryan Gerard is an individual health care provider with primary practice located at 8119 Connector Dr , Florence KY 41042-1469. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Boudreaux, Bryan Gerard can be contacted via phone (859) 283-2475.

Contact Information

Primary practice address
8119 Connector Dr Florence KY 41042-1469
Phone: (859) 283-2475
Fax: (859) 283-0097
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 5496 Kentucky

Profile Details

NPI number 1770546038
LBN Legal business name Boudreaux, Bryan Gerard
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 8th, 2006
Last updated Sep 14th, 2017 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770546038 NPPES
Kentucky Other K168830 MEDICARE PTAN

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