NPI 1114937000

Earl Douglas Bourgoyne, BSCPO

Practitioner Orthotic Fitter Albuquerque, NM

Practice location

Address: 1501 San Pedro Dr SE, Albuquerque, NM 87108-5153
Phone: (505) 256-2756
Mailing address: 617 Rio Hondo Rd NE, Rio Rancho, NM 87144-4717

Registered specialties

Orthotic Fitter Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225000000X

Other Orthotic Fitter providers in New Mexico →

Registry record

NPI: 1114937000
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Aug 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.