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Individual

DR. JACQUES MAURICE BOUCHARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
515 S ALMON ST APT A, MOSCOW, ID 83843-2986
(208) 550-3060
(208) 210-1640
Mailing address
515 S ALMON ST APT A, MOSCOW, ID 83843-2986
(208) 550-3060
(208) 210-1640

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-14719
ID

Other

Enumeration date
04/30/2012
Last updated
11/13/2024
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