OTIS J BOURG

HOUMA, LA
NPI1114009313
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy152W00000X Optometrist
(Licence: LA  LA666265T)
Enumeration Date2006-10-19
Last Update Date2009-03-11
Business Address
Dr. OTIS J BOURG O. D.
832 BELANGER ST
HOUMA, LA 70360-4408
Phone number: 985-872-1494
Mailing Address
Dr. OTIS J BOURG O. D.
832 BELANGER ST
HOUMA, LA 70360-4408
Phone number:
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