Individual
JULIA BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
776 LONGMEADOW ST, LONGMEADOW, MA 01106-2219
(413) 565-4400
(413) 565-4411
Mailing address
776 LONGMEADOW ST, LONGMEADOW, MA 01106-2219
(413) 565-4400
(413) 565-4411
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA4237
MA
Other
Enumeration date
09/26/2011
Last updated
01/20/2012
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