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Individual

SAMUEL BOUCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
750 N MAIN ST, LOGAN, UT 84321-3227
(435) 753-1643
Mailing address
750 N MAIN ST, LOGAN, UT 84321-3227

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
357717-1701
UT

Other

Enumeration date
10/03/2019
Last updated
10/03/2019
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