Individual
MR. MATTHEW JOSEPH BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T.
Contact information
Practice address
404 STATE ST, SUITE #610, BANGOR, ME 04401-6623
(207) 947-8381
Mailing address
27 AIRPORT RD, ENFIELD, ME 04493-4455
(207) 659-2258
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3456
ME
Other
Enumeration date
02/21/2011
Last updated
02/21/2011
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