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Individual

BRENDAN BOUCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
2144 E REPUBLIC RD STE A104, SPRINGFIELD, MO 65804-4645
(417) 887-8075
(417) 887-8535
Mailing address
2144 E REPUBLIC RD STE A104, SPRINGFIELD, MO 65804-4645
(417) 887-8075
(417) 887-8535

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
20240363625
MO

Other

Enumeration date
09/05/2024
Last updated
09/05/2024
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