Individual
COURTNEY BOUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
503 N STORY PL, ALHAMBRA, CA 91801-2608
(626) 484-6732
Mailing address
503 N STORY PL, ALHAMBRA, CA 91801-2608
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
52658
CA
Other
Enumeration date
07/25/2015
Last updated
10/27/2021
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