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General NPI Number Information
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NPI Number | 1881021012
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Entity Type | Organization
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Legal Business Name | BOYLE HEALTH SERVICES, PLLC
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Dates
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Enumeration Date | 10/02/2013
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 1515 N SAN FRANCISCO ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-1435
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Country | US
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Telephone | 928-774-0108
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Fax | 928-774-2801
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Provider Business Mailing Address
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Address Line | 1515 N SAN FRANCISCO ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-1435
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Country | US
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Telephone | 928-774-0108
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Fax | 928-774-2801
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Authorized Official
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Title or Position | PHYSICIAN
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Name | HEATHER K BOYLE
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Credential | M.C.
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Telephone | 928-774-0108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 38148
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License Number State | AZ
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