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1548093842
LOUIS BOUCHARD
SAN DIEGO, CA
NPI
1548093842
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2024-08-22
Last Update Date
2024-08-22
Business Address
LOUIS BOUCHARD IDC
34101 FARENHOLT AVE
SAN DIEGO, CA 92134-7000
Phone number: 570-903-2785
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Mailing Address
LOUIS BOUCHARD IDC
303 SUGARBERRY CT
JACKSONVILLE, NC 28540-8833
Phone number: 570-903-2785
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