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General NPI Number Information
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NPI Number | 1629078159
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Entity Type | Individual
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Provider Name | BRIAN JOSEPH BOYLE PT,DPT
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Gender | Male
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Dates
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Enumeration Date | 07/27/2005
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Last Update Date | 10/08/2012
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Provider Practice Location Address
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Address Line | 128 SPEEDWAY DR
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City | MOORESVILLE
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State | NC
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Zip | 28117-6879
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Country | US
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Telephone | 704-768-1013
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Fax | 704-264-0711
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Provider Business Mailing Address
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Address Line | PO BOX 69
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City | LOWELL
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State | NC
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Zip | 28098-0069
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Country | US
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Telephone | 704-241-0889
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Fax | 704-864-2125
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 8975
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License Number State | NC
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