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General NPI Number Information
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NPI Number | 1922195916
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Entity Type | Individual
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Provider Name | BRIDGET M BOYLAN PT, LAC
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 517 E MAGNOLIA ST
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City | BELLINGHAM
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State | WA
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Zip | 98225-4529
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Country | US
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Telephone | 503-610-0834
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Fax | 888-746-2736
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Provider Business Mailing Address
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Address Line | PO BOX 30756
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City | BELLINGHAM
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State | WA
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Zip | 98228-2756
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Country | US
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Telephone | 206-772-5315
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Fax | 206-774-8751
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC2691
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5456
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License Number State | WA
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