Ryan Jacob Boudreaux
Physical Therapist - Neurology
1462 Clifton Rd Ne Ste 312
Atlanta
, Georgia 30322-1000
Ryan Jacob Boudreaux
Physical Therapist - Neurology
1462 Clifton Rd Ne Ste 312
Atlanta
, Georgia 30322-1000
(941) 232-3883
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About
Features
Specialties
- Physical Therapist - Neurology
Languages spoken
- English
Location
First Address
- Ryan Jacob Boudreaux
- 265 Ponce De Leon Ave Ne Unit 2115
- Atlanta, GA
- Zip : 30308-1999
- Phone : (941) 232-3883
Second Address
- Ryan Jacob Boudreaux
- 1462 Clifton Rd Ne Ste 312
- Atlanta, GA
- Zip : 30322-1000
- Phone : (404) 727-4002
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2251N0400X | Physical Therapist - Neurology | PT011641 | GA |
National Provider Identifier
| NPI | 1225437866 |
|---|---|
| Provider Name | Ryan Jacob Boudreaux |
| First Address | Atlanta, GA 30308-1999 |
| Second Address | Atlanta, GA 30322-1000 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/08/2014 |
| Last Update Date | 20/08/2014 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.