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Individual

MRS. CARRIE ELAINE BOUCHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
210 PROFESSIONAL PARK DR SE STE 10, BLACKSBURG, VA 24060-6649
(540) 605-8751
(540) 750-4062
Mailing address
125 HAYMAKER ST, CHRISTIANSBURG, VA 24073-3115
(540) 449-4235

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019006762
VA

Other

Enumeration date
04/21/2011
Last updated
09/06/2021
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