Individual
MS. RENEE M BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, ATC, LAT
Contact information
Practice address
800 SOUTH ST, BARRE, MA 01005-8906
(978) 355-5041
Mailing address
PO BOX 442, BARRE, MA 01005-0442
(401) 440-6369
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
01770
MA
Other
Enumeration date
02/20/2007
Last updated
10/25/2016
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