Todd Michael Boucher, PA-C
Physician Assistant, Medical in Aurora, CO. Individual provider (NPI-1).
NPI number1053884635
StatusActive
Last updated in NPPESJul 5, 2022
Details
- NPI
- 1053884635
- Entity type
- Individual (NPI-1)
- Name
- Todd Michael Boucher
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 7, 2019
- Certification date
- Jul 5, 2022
- Last updated
- Jul 5, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | PA.0005535 | CO | Yes |
Practice location
16951 E Quincy AveAurora, CO 80015-1901
Phone 303-752-5480 · Fax 303-752-5481
Mailing address
2695 Rocky Mountain Ave Ste 150Loveland, CO 80538-9071
Phone 970-624-4123 · Fax 970-624-2416
Other practice locations
6256 Oxford Peak Ct
Castle Rock, CO 80108-9467
Castle Rock, CO 80108-9467
Phone 720-485-1981
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