Organization
CENTRAL CONNECTICUT FOOTCARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TINA ANNE BOUCHER DPM (OWNER)
(203) 238-3668
Entity
Organization
Contact information
Practice address
807 BROAD ST., MERIDEN, CT 06450-3802
(203) 238-3668
(203) 238-3670
Mailing address
807 BROAD ST, MERIDEN, CT 06450-4301
(203) 238-3668
(203) 238-3670
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
000805
CT
Other
Enumeration date
10/20/2006
Last updated
08/23/2010
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