| Doctor Name: | KRISTEN BOUCHARD |
| NPI Number: | 1821157280 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | 5632 |
| Business Practice Address: | 1019 Tiger Blvd Suite 105 Clemson, SC - 296312916 |
| Business Phone Number: | 8646540431 |
| Business Fax Number: | 8646540799 |
| Mailing Address: | Po Box 1844, CLEMSON |
| State: | SC |
| Postal Code: | 296331844 |
| Phone Number: | 8644820064 |
| Fax Number: | 6844820081 |
| NPI Enumeration Date: | 12/08/2006 |
| NPI Last Update Date: | 02/06/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5632 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SC |
| 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 |