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Individual

JACQUELINE MARIE BOUCHER-STEWART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1220 E ELM ST, SUITE 205, LIMA, OH 45804-2850
(419) 224-5437
Mailing address
1220 E ELM ST, SUITE 205, LIMA, OH 45804-2850
(419) 224-5437

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.003247
OH

Other

Enumeration date
04/24/2011
Last updated
04/27/2021
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