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General NPI Number Information
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NPI Number | 1013720200
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Entity Type | Individual
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Provider Name | LARRY BOYER OTD, OTR/L
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Gender | Male
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 1349 E 79TH ST
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City | CLEVELAND
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State | OH
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Zip | 44103-2864
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Country | US
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Telephone | 216-324-0763
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Fax |
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Provider Business Mailing Address
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Address Line | 31860 RUSTIC RDG
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City | NORTH RIDGEVILLE
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State | OH
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Zip | 44039-7327
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT013144
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License Number State | OH
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