Individual
MR. BRIAN ERIC BOUTILIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
19 HODSKIN ST, CANTON, NY 13617-1175
(315) 379-0992
(315) 370-0993
Mailing address
19 HODSKIN ST, CANTON, NY 13617-1175
(315) 379-0992
(315) 370-0993
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
018314-1
NY
Other
Enumeration date
10/21/2005
Last updated
07/07/2008
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