Healthcare Provider Details

I. General information

NPI: 1700306685
Provider Name (Legal Business Name): VIRGINIA FREEMAN BOYD RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2017
Last Update Date: 06/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SAVAHCS 3601 SOUTH 6TH AVENUE
TUCSON AZ
85723
US

IV. Provider business mailing address

7595 E SHADYBROOK LN
TUCSON AZ
85756-6168
US

V. Phone/Fax

Practice location:
  • Phone: 520-792-1450
  • Fax: 520-629-1779
Mailing address:
  • Phone: 520-891-3570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number012236
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: