Individual
JONATHAN BOUTNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
10293 DIXIE HIGHWAY, SUITE 0, HOLLY, MI 48442
(810) 771-7686
(810) 771-7685
Mailing address
P O BOX 32008, FLINT, MI 48507
(810) 230-0338
(810) 715-5005
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501015725
MI
Other
Enumeration date
10/10/2011
Last updated
10/19/2011
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