Provider Demographics
NPI:1245327683
Name:BOMBARDIER, LINDA ANNE (PT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ANNE
Last Name:BOMBARDIER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14248 HIGHWAY 1085
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-6906
Mailing Address - Country:US
Mailing Address - Phone:504-277-6052
Mailing Address - Fax:504-277-6053
Practice Address - Street 1:8101 W JUDGE PEREZ DR
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-1659
Practice Address - Country:US
Practice Address - Phone:504-277-6052
Practice Address - Fax:504-277-6053
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT00481225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist