Healthcare Provider Details

I. General information

NPI: 1194879148
Provider Name (Legal Business Name): MARIAN C BOYD RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 BURNHAM ST
TURNERS FALLS MA
01376-1841
US

IV. Provider business mailing address

574 COUNTRY CLUB RD
GREENFIELD MA
01301-9785
US

V. Phone/Fax

Practice location:
  • Phone: 413-774-7988
  • Fax: 413-773-7322
Mailing address:
  • Phone: 413-774-7988
  • Fax: 413-773-7322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number2160
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: