Individual
TAMMY H BOUCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
3540 VICTORY BLVD, YORKTOWN, VA 23693-3641
(757) 230-2202
Mailing address
108 BLACKSMITH ARCH, YORKTOWN, VA 23693-4506
(757) 739-4697
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306000583
VA
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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