Individual provider · Type 1 NPI

Earl Douglas Bourgoyne, BSCPO

Orthotic Fitter · Albuquerque, NM

NPI number 1114937000 Active

Practice location

1501 San Pedro Dr SE
Albuquerque, NM 87108-5153

Call (505) 256-2756 Map

Mailing address

617 Rio Hondo Rd NE
Rio Rancho, NM 87144-4717

Specialties and licenses

TaxonomyCodeLicense
Orthotic Fitter Primary 225000000XNone listed

Orthotic Fitter: An individual trained in the management of fitting prefabricated orthoses.

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About NPI 1114937000

Earl Douglas Bourgoyne, BSCPO's National Provider Identifier is 1114937000, issued on Aug 9, 2006. The primary taxonomy on file is Orthotic Fitter (225000000X), and the practice location is in Albuquerque, NM. The record was last updated on Jul 8, 2007.