Healthcare Provider Details

I. General information

NPI: 1265624449
Provider Name (Legal Business Name): TODD M BOYCE OT-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6545 FRANCE AVE S SUITE 160
EDINA MN
55435-2131
US

IV. Provider business mailing address

701 25TH AVE S SUITE 505
MINNEAPOLIS MN
55454-1513
US

V. Phone/Fax

Practice location:
  • Phone: 952-835-0750
  • Fax: 952-835-0662
Mailing address:
  • Phone: 612-455-2013
  • Fax: 612-455-2045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: