Individual
LEAH J BOUTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
390 ORBITING DRIVE, MOSINEE, WI 54455
(715) 693-9100
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5777
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9961
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40377200
—
WI
Enumeration date
09/25/2006
Last updated
07/08/2007
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