Gene Louis Boucher, DC Valid NPI

Individual provider · Chiropractor · Fairfield, NJ

NPI

1184694788

Type

Individual (Type 1)

Primary specialty

Chiropractor

Specialty group

Chiropractic Providers

Taxonomy code

111N00000X

License number

MC005511 (NJ)

Sex

Male

Sole proprietor

Yes

Enumerated

2006-01-25

Last updated

2020-04-03