Individual
MR. BRIAN M BOUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1075 S IDAHO, #210, APACHE JUNCTION, AZ 85219
(480) 983-0877
(480) 983-3172
Mailing address
3941 E BASELINE, #101, GILBERT, AZ 85234
(480) 503-2010
(480) 503-2300
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6233
AZ
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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