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NPI Code Detail

MEDICARE: KATHLEEN MARIE BOYLE

MEDICARE: KATHLEEN MARIE BOYLE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251P0200XPediatric Physical TherapistPT008292LPA

General Provider Information

NPI Number : 1316128721
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN MARIE BOYLE
Provider Business Mailing Address
First Line : 2314 E BUCK RD
Second Line :
City : PENNSBURG
State : PA
Zip : 18073-2327
Country : US
Telephone Number : 215-679-8268
Fax Number :
Provider Business Practice Location Address
First Line : 2314 E BUCK RD
Second Line :
City : PENNSBURG
State : PA
Zip : 18073-2327
Country : US
Telephone Number : 215-206-5013
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2007
Last Update Date : 03/20/2008

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