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Individual

ANTHONY MANNING BOUCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
8885 HWY 34 SOUTH, QUINLAN, TX 75474
(903) 356-4100
(903) 356-4140
Mailing address
PO BOX 2500, ROCKWALL, TX 75087
(972) 771-0999
(972) 771-2281

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1105583
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
165348701
TX
Enumeration date
12/14/2006
Last updated
02/21/2008
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