| Doctor Name: | MRS. ANDREA L LADOUCEUR |
| NPI Number: | 1275506768 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | PT-1984 |
| Business Practice Address: | 5255 Overland Rd Boise, ID - 837052637 |
| Business Phone Number: | 2083389486 |
| Business Fax Number: | 2083389586 |
| Mailing Address: | 704 N Gail Pl, BOISE |
| State: | ID |
| Postal Code: | 837062056 |
| Phone Number: | 2187795570 |
| Fax Number: | |
| NPI Enumeration Date: | 02/07/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT-1984 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |