Individual
MRS. PATRICIA BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
65 LIBBY ST, BROCKTON, MA 02302-2949
(508) 584-6060
Mailing address
65 LIBBY ST, BROCKTON, MA 02302-2949
(508) 584-6060
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
RN172200
MA
Other
Enumeration date
07/07/2010
Last updated
07/07/2010
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