MEDICARE: DR. SAMANTHA ADDIE BOYD D.C.

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	111N00000X	Chiropractor	CH10166	FL

General Provider Information

NPI Number	:	1194029090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMANTHA ADDIE BOYD D.C.

Provider Business Mailing Address
First Line	:	9710 STIRLING RD
Second Line	:	112
City	:	COOPER CITY
State	:	FL
Zip	:	33024
Country	:	US
Telephone Number	:	954-704-1224
Fax Number	:

Provider Business Practice Location Address
First Line	:	9710 STIRLING RD
Second Line	:	112
City	:	COOPER CITY
State	:	FL
Zip	:	33024
Country	:	US
Telephone Number	:	954-704-1224
Fax Number	:

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

Provider Enumeration Date	:	01/06/2011
Last Update Date	:	06/01/2012

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