NPI 1013062405

Jacque Arlin Boutwell, CFA

Practitioner Surgical Assistant Elkhart, IN

Practice location

Address: 3301 County Rd 6 E, Elkhart, IN 46514-7673
Phone: (574) 214-7504
Fax: (574) 262-3214
Mailing address: 5146 Reliable Pkwy, Chicago, IL 60686-0001

Registered specialties (2)

Surgical Assistant Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246ZC0007X

Other Specialist/Technologist, Other providers in Indiana →

Surgical Technologist

Technologists, Technicians & Other Technical Service Providers Taxonomy 246ZS0410X

Registry record

NPI: 1013062405
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Jan 2007
Record last updated: 25 Nov 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.