Individual
DAVID J BOUCHER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1001 WATERMAN AVE, E PROVIDENCE, RI 02914-1314
(401) 434-1773
(401) 435-0500
Mailing address
31 OLD ROUTE 7, ATTN: CREDENTIALING DEPT, BROOKFIELD, CT 06804-1714
(203) 740-0020
(203) 775-0238
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01754
RI
Other
Enumeration date
05/19/2006
Last updated
07/08/2007
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