Individual
JEFFREY S BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
59 BANGOR ST, HOULTON, ME 04730-1740
(207) 538-3700
(207) 528-2880
Mailing address
529 S PATTEN RD, PATTEN, ME 04765-3007
(207) 538-3700
(207) 528-2880
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN12168
ME
Other
Enumeration date
11/15/2023
Last updated
11/15/2023
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