Provider Demographics
NPI:1659859643
Name:BOUCHER, ARIANA CARMEN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ARIANA
Middle Name:CARMEN
Last Name:BOUCHER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 GREENVILLE BLVD SE STE B3
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5758
Mailing Address - Country:US
Mailing Address - Phone:252-215-5225
Mailing Address - Fax:252-215-5226
Practice Address - Street 1:308 GREENVILLE BLVD SE STE B3
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858
Practice Address - Country:US
Practice Address - Phone:252-215-5225
Practice Address - Fax:252-215-5226
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist