MEDICARE: MR. PAUL DAVID BOYS P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT-009990	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184950305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PAUL DAVID BOYS P.T.

Provider Business Mailing Address
First Line	:	4555 LAKE FOREST DR
Second Line	:	STE 150
City	:	CINCINNATI
State	:	OH
Zip	:	45242-3781
Country	:	US
Telephone Number	:	877-327-2278
Fax Number	:	888-322-2278

Provider Business Practice Location Address
First Line	:	4555 LAKE FOREST DR
Second Line	:	STE 150
City	:	CINCINNATI
State	:	OH
Zip	:	45242-3781
Country	:	US
Telephone Number	:	877-327-2278
Fax Number	:	888-322-2278

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2009
Last Update Date	:	08/10/2010

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Directions to “ MR. PAUL DAVID BOYS P.T.” Practice Location

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