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Individual

MR. JAMIE DAVID BOUDREAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
19 N MAIN ST, DERRY, NH 03038-1208
(603) 437-5200
(603) 437-5244
Mailing address
114 HELEN DEARBORN RD, WEARE, NH 03281-5816
(603) 437-5200
(603) 437-5244

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0072
NH

Other

Enumeration date
04/01/2019
Last updated
04/01/2019
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