Provider Demographics
NPI:1003461682
Name:BOUZIGARD, AUSTIN A (DC)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:A
Last Name:BOUZIGARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 117
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:LA
Mailing Address - Zip Code:70374-0117
Mailing Address - Country:US
Mailing Address - Phone:985-532-6800
Mailing Address - Fax:985-532-6813
Practice Address - Street 1:5550 N HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:LA
Practice Address - Zip Code:70374-2000
Practice Address - Country:US
Practice Address - Phone:985-532-6800
Practice Address - Fax:985-532-6813
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1869111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor