Most Relevant Information
Provider Data
| NPI Number: | 1003641333 |
| Provider Name: | BRENDAN BOUCHER DC |
| Entity Type: | Individual |
| Taxonomy Code: | 111N00000X |
| Specialty: | Chiropractor |
| License Number: | 20240363625 |
Most Important Dates
| Enumeration Date: | 09/05/2024 |
| Last Updated: | 09/05/2024 |
Provider Practice Location
2144 E REPUBLIC RD STE A104
SPRINGFIELD
MO
658044645
Practice Location Phone/Fax
| Phone: | 4178878075 |
| Fax: | 4178878535 |
Provider Mailing Location
2144 E REPUBLIC RD STE A104
SPRINGFIELD
MO
658044645
Provider Mailing Phone/Fax
| Phone: | 4178878075 |
| Fax: | 4178878535 |