Healthcare Provider Details

I. General information

NPI: 1720914187
Provider Name (Legal Business Name): ABIGAIL BOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 CAMPUS DR
MISSOULA MT
59801-4494
US

IV. Provider business mailing address

3000 S HIGGINS AVE APT A14
MISSOULA MT
59801-6942
US

V. Phone/Fax

Practice location:
  • Phone: 209-251-9230
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: