Individual
MICHELLE BOUCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C. , P.C.
Contact information
Practice address
928 BROADWAY, SUITE 1205, NEW YORK, NY 10010
(212) 358-0820
Mailing address
928 BROADWAY SUITE 1205, NEW YORK, NY 10010
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X008233-1
NY
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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