Individual
DR. BRANT DERWENT BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
171 TAYLOR ST, HARPERS FERRY, WV 25425-3641
(304) 535-6343
(304) 596-2840
Mailing address
171 TAYLOR ST, HARPERS FERRY, WV 25425-3641
(304) 535-6343
(304) 596-2840
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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