Individual
JULIE BOUCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3000 FORD STREET EXT, OGDENSBURG, NY 13669-4480
(315) 394-7902
Mailing address
1120 WASHINGTON ST, OGDENSBURG, NY 13669-1838
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
C006115
NY
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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