Individual
JENNIFER BOUCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
13650 HEATHCOTE BLVD, GAINESVILLE, VA 20155-3344
(571) 284-7244
Mailing address
775 GATEWAY DR SE APT 922, LEESBURG, VA 20175-4042
(703) 909-7707
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306603592
VA
Other
Enumeration date
06/21/2018
Last updated
06/21/2018
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