Doctor Name: | MR. BRIAN JOSEPH BOURDEAU |
NPI Number: | 1336138288 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | PT21211 |
Business Practice Address: | 3651 Cortez Rd W Ste 100 Bradenton, FL - 342103167 |
Business Phone Number: | 9417397828 |
Business Fax Number: | 9417397838 |
Mailing Address: | 3651 Cortez Rd W, Ste 100 BRADENTON |
State: | FL |
Postal Code: | 342103167 |
Phone Number: | 9417397828 |
Fax Number: | 9417397838 |
NPI Enumeration Date: | 10/13/2005 |
NPI Last Update Date: | 02/16/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT21211 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |