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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MATTHEW CHARLES BOUCHE, PT, CSCS

Active

MATTHEW CHARLES BOUCHE, PT, CSCS is a Environmental Modification (OT) healthcare provider located in ST. PAUL, Minnesota. NPI 1033785027 is currently active in the NPPES registry. Verify at CMS.

Environmental Modification (OT) · ST. PAUL, MN

Registration Details

NPI Number
1033785027
Provider Type
Individual
Gender
Male
NPI Issued
Jun 1, 2021 (5.2146750918291 yrs)
Last Updated
Jun 1, 2021
Licenses
11806 (MN)
11806 (MN)

Practice Information

Address
2155 FORD PARKWAY
ST. PAUL, MN, 551161862
Browse MN providers · Browse ZIP 55116
Phone
6516965010
Primary Specialty
Environmental Modification (OT)
2251S0007X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.