Individual
CHARLEEN BOUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.T.
Contact information
Practice address
2149 ROCKLYN ST, CAMARILLO, CA 93010-3332
(760) 331-8526
Mailing address
3418 LOMA VISTA RD, STE A, VENTURA, CA 93003-3015
(805) 765-4773
(805) 258-7039
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
292463
CA
Other
Enumeration date
11/19/2016
Last updated
12/02/2016
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