Individual
LUIS J BOULIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
908 S GARDEN LAKE DR, ST AUGUSTINE, FL 32086-5236
(850) 502-9840
Mailing address
908 S GARDEN LAKE DR, ST AUGUSTINE, FL 32086-5236
(850) 502-9840
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18612
FL
Other
Enumeration date
10/28/2021
Last updated
10/28/2021
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