| NPI | 1871774034 |
|---|---|
| Former Legal Business Name | KEVIN E BOUCHER, DO |
| Entity Type | Organization |
| Authorized Contact | KEVIN E BOUCHER Owner 860-974-0529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 000211) |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2010-04-20 |