Most Relevant Information
Provider Data
NPI Number: | 1003004532 |
Provider Name: | DONALD FRANCIS BOUCHARD |
Entity Type: | Individual |
Taxonomy Code: | 171W00000X |
Specialty: | Contractor |
License Number: |
Most Important Dates
Enumeration Date: | 10/10/2007 |
Last Updated: | 10/10/2007 |
Provider Practice Location
17 WATERHOUSE LN
CHESTER
CT
064121267
Practice Location Phone/Fax
Phone: | 8605264333 |
Fax: | 8605264333 |
Provider Mailing Location
17 WATERHOUSE LN
GOLDSTAR MEDICAL SERVICES, INC.
CHESTER
CT
06412
Provider Mailing Phone/Fax
Phone: | 8605264333 |
Fax: | 8605264333 |