Individual
MARY JENNINGS BOUCHILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2319 HIGHWAY 145, SALTILLO, MS 38866-9199
(662) 869-9980
(662) 869-9970
Mailing address
8205 PRESIDENTS DR, HUMMELSTOWN, PA 17036-8621
(717) 839-2188
(717) 565-1104
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6886
MS
Other
Enumeration date
06/26/2020
Last updated
06/26/2020
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