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Individual
R CHRISTOPHER BOUTON
Active
Individual
R CHRISTOPHER BOUTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0143541
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02071589
—
NY
01
—
04102500062
FIDELIS
—
01
—
10058323
CDPHP
—
01
—
435054
MVP
—
01
—
6699194
GHI
—
01
—
7164110
AETNA
—
Enumeration date
08/10/2006
Last updated
07/08/2007
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