| Doctor Name: | TODD BOURGEOIS |
| NPI Number: | 1598937815 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | PT23853 |
| Business Practice Address: | 12671 Us Highway 98 W Ste 213 Destin, FL - 325508300 |
| Business Phone Number: | 8506504186 |
| Business Fax Number: | 8506504188 |
| Mailing Address: | 1950 Bluewater Blvd, Ste 101 NICEVILLE |
| State: | FL |
| Postal Code: | 325783887 |
| Phone Number: | 8508973334 |
| Fax Number: | 8508977855 |
| NPI Enumeration Date: | 03/26/2008 |
| NPI Last Update Date: | 05/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT23853 |
| 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 |