Cierra Jean Boutelle is a Student in the OSHKOSH area. Cierra Jean Boutelle primary office location is at 4391 SODA CREEK RD APT 4 and new patients are welcome to contact this healthcare provider for an appointment. The NPI number is 1164137972 and the information was updated less than a year ago.
We have not detected any Exclusions tied directly to this NPI.
Accepts Medicare Assignment: Unknown
Is sole proprietor: YES
Participates in PECOS: NO
Taxonomy | State | Primary? |
---|---|---|
Student - Taxonomy Code 390200000X | -- | Y |
Athletic Trainer - Taxonomy Code 2255A2300X | -- | N |