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Individual

JONATHON DAVID BOUFFARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MOT, OTR/L

Contact information

Practice address
130 PRESTONIAN PL, MORRISVILLE, NC 27560-7065
(540) 323-0014
Mailing address
130 PRESTONIAN PL, MORRISVILLE, NC 27560-7065

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
021955-1
NY
225X00000X
Occupational Therapist
Primary
9623
NC

Other

Enumeration date
11/16/2017
Last updated
11/16/2017
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