Doctor Name: | JOHN R BOUCHER |
NPI Number: | 1457371718 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | 05269 |
Business Practice Address: | 1430 W Baddour Pkwy Suite C Lebanon, TN - 370872656 |
Business Phone Number: | 6154531422 |
Business Fax Number: | 6154531429 |
Mailing Address: | 1430 W Baddour Pkwy, Suite C LEBANON |
State: | TN |
Postal Code: | 370872656 |
Phone Number: | 6154531422 |
Fax Number: | 6154531429 |
NPI Enumeration Date: | 07/20/2006 |
NPI Last Update Date: | 10/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 05269 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |