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DR. KEVIN LAWRENCE BOUDREAU D.C.
>> Chiropractor >> Chiropractic ProvidersRegistrant NPI Number: 1679516223
Individual Registrant:DR. KEVIN LAWRENCE BOUDREAU D.C.
Gender: M
Gender: M
Location and contact information for practice:
116 N 9TH ST SUITE A GLADSTONE, MI 49837-1645 US
Tel: 906-428-9640 Fax: 906-428-9641
Tel: 906-428-9640 Fax: 906-428-9641
Contact information for business:
116 N 9TH ST SUITE A GLADSTONE, MI 49837-1645 US
Tel: 906-428-9640 Fax: 906-428-9641
Tel: 906-428-9640 Fax: 906-428-9641
Registration Information:
NPI: 1679516223
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 111N00000X | Chiropractic Providers Chiropractor | MI | 2301008810 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
