Healthcare Provider Details

I. General information

NPI: 1700367620
Provider Name (Legal Business Name): AMBER BOYD PT, DPT, DHSC, SCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 PIEDMONT AVE STE 2300
CINCINNATI OH
45219-4215
US

IV. Provider business mailing address

504 GENERAL DR
FT WRIGHT KY
41011-1836
US

V. Phone/Fax

Practice location:
  • Phone: 513-621-7777
  • Fax:
Mailing address:
  • Phone: 765-265-5030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT012817
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: