Individual
KEITH BOUVIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
44 CANTERBURY RD, BROOKLYN, CT 06234-1914
(860) 774-9050
Mailing address
204 GOOSENECK HILL RD, CANTERBURY, CT 06331-1815
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3504
CT
Other
Enumeration date
04/04/2023
Last updated
04/04/2023
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