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1265663587
MICHAEL RAYMOND BOULTER
CASPER, WY
NPI
1265663587
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WY PT-1283)
Enumeration Date
2009-08-04
Last Update Date
2009-08-04
Business Address
-- MICHAEL RAYMOND BOULTER DPT
311 THELMA DR
CASPER, WY 82609-2325
Phone number: 307-234-2662
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Mailing Address
-- MICHAEL RAYMOND BOULTER DPT
PO BOX 1790
DOUGLAS, WY 82633-1790
Phone number: 307-358-9464
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