Individual
LISA M BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
265 E MARION AVE, PUNTA GORDA, FL 33950-3715
(941) 629-8001
(941) 766-0001
Mailing address
27511 LIPPIZZAN TRL, PUNTA GORDA, FL 33950-8331
(941) 421-2116
(941) 421-2116
Taxonomy
Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
Primary
53741
MA
Other
Enumeration date
10/09/2007
Last updated
10/14/2009
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