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Individual

JOSHUA P BOUCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
4027 MILL ST, KANSAS CITY, MO 64111-3008
(816) 561-1665
Mailing address
1605 NW SUNRIDGE DR, BLUE SPRINGS, MO 64015-3536
(816) 721-8169

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1735
KS
152W00000X
Optometrist
2005027604
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
152W00000X
OPTOMETRY
MO
Enumeration date
10/16/2006
Last updated
03/20/2023
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