Individual
MISS LAURA MICHELLE BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6475 S YALE AVE STE 308, TULSA, OK 74136-7802
(918) 499-4000
(918) 499-4001
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2883
OK
Other
Enumeration date
03/01/2018
Last updated
11/21/2023
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