Individual
MR. PAUL R BOUCHILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
65 DUTCH LN, COLUMBUS, MS 39702-5523
(662) 327-6705
(662) 327-6760
Mailing address
65 DUTCH LN, COLUMBUS, MS 39702-5523
(662) 327-6705
(662) 327-6760
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0953
MS
Other
Enumeration date
05/03/2006
Last updated
01/02/2013
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