Healthcare Provider Details

I. General information

NPI: 1376459222
Provider Name (Legal Business Name): AIDAN M BOYD DPT, PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2169 W M 43 HWY
HASTINGS MI
49058-8577
US

IV. Provider business mailing address

5060 CASCADE RD SE STE A
GRAND RAPIDS MI
49546-3808
US

V. Phone/Fax

Practice location:
  • Phone: 269-309-1090
  • Fax: 616-259-5739
Mailing address:
  • Phone: 269-309-1090
  • Fax: 616-259-5739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501304618
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: