Individual
MS. GLORIA BOUCHARD VILLARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, MT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
040.0003720
VT
225100000X
Physical Therapist
Primary
3547
MA
225700000X
Massage Therapist
1663
MA
Other
Enumeration date
01/23/2012
Last updated
01/23/2012
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