Individual
ROBERT BOUCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3529 SUPERIOR AVE, SHEBOYGAN, WI 53081-1865
(920) 459-2755
(920) 803-7519
Mailing address
1111 PARTRIDGE RUN, SHEBOYGAN FALLS, WI 53085-1846
(920) 467-4046
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9741-042
WI
Other
Enumeration date
11/24/2006
Last updated
07/08/2007
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