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General NPI Number Information
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NPI Number | 1831617422
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Entity Type | Individual
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Provider Name | KATHRYN RUTH BOYLAN
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Gender | Female
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Dates
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Enumeration Date | 09/02/2017
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Last Update Date | 02/20/2020
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Provider Practice Location Address
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Address Line | 6262 VETERANS PKWY
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City | COLUMBUS
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State | GA
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Zip | 31909-3540
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Country | US
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Telephone | 706-266-3866
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Fax |
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Provider Business Mailing Address
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Address Line | 41 FORD DR SE
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City | ROME
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State | GA
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Zip | 30161-8617
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Country | US
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Telephone | 706-266-6224
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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