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MRS. TONI EDWARDS BOUCK O.T.R,

>> Rehabilitation Unit >> Hospital Units

Registrant NPI Number: 1770715138

Individual Registrant:
MRS. TONI EDWARDS BOUCK O.T.R,
Gender: F
Sole Proprietor

Location and contact information for practice:
3964 FLORIDA AVE  JAY, FL 32565-1104 US
Tel: 850-741-6715  Fax: --

Contact information for business:
3331 SUMMIT BLVD APT 172  PENSACOLA, FL 32503-4331 US
Tel: 850-741-6715  Fax: --

Registration Information:
NPI: 1770715138
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N273Y00000XHospital Units
Rehabilitation Unit
FL27-0596759
Y225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Occupational Therapist
FL12040

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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