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Individual
ALAN JACOB BOUCHER
Active
Individual
ALAN JACOB BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
129213
OH
Other
Enumeration date
05/08/2013
Last updated
02/08/2018
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