MEDICARE: YVONNE LADOUCEUR PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	P14100	NC

General Provider Information

NPI Number	:	1942549332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVONNE LADOUCEUR PT

Provider Business Mailing Address
First Line	:	2111 NEUSE BLVD STE K
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28560-4318
Country	:	US
Telephone Number	:	252-637-5001
Fax Number	:	252-637-5007

Provider Business Practice Location Address
First Line	:	2111 NEUSE BLVD STE K
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28560-4318
Country	:	US
Telephone Number	:	252-637-5001
Fax Number	:	252-637-5007

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2013
Last Update Date	:	02/06/2013

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Directions to “ YVONNE LADOUCEUR PT” Practice Location

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