Individual provider · NPI-1

Quinn Patrick Bourgeois Sr.

Driver · New Orleans, LA

NPI number1124509237
StatusActive
Last updated in NPPESAug 27, 2018

Details

NPI
1124509237
Entity type
Individual (NPI-1)
Name
Quinn Patrick Bourgeois Sr.
Sex
Male
Sole proprietor
No
Enumeration date
Aug 27, 2018
Last updated
Aug 27, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
172A00000X Driver–LAYes

Practice location

5720 St.Roch Ave
New Orleans, LA 70122

Phone 504-382-8396

Mailing address

5720 St.Roch Ave
New Orleans, LA 70122

Phone 504-382-8396

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