Individual
JULIE ANNE BOUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2915 NORTH 4TH STREET, FLAGSTAFF, AZ 86004
(928) 779-1679
(928) 779-2822
Mailing address
2915 NORTH 4TH STREET, FLAGSTAFF, AZ 86004
(928) 779-1679
(928) 779-2822
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
30906
AZ
225100000X
Physical Therapist
348046-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
607102
—
AZ
Enumeration date
08/30/2006
Last updated
07/02/2020
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