TYLER BOUCHARD

DAVIS, CA
NPI1649887076
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: CA  PTA50692)
Enumeration Date2020-09-29
Last Update Date2020-09-29
Business Address
TYLER BOUCHARD
1515 SHASTA DR
DAVIS, CA 95616-6691
Phone number: 707-803-3156
Mailing Address
TYLER BOUCHARD
4560 SE INTERNATIONAL WAY STE 100
MILWAUKIE, OR 97222-4628
Phone number: