MEDICARE: MS. LORA JANE BOYCE

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	372600000X	Adult Companion

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

General Provider Information

NPI Number	:	1215142187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LORA JANE BOYCE

Provider Business Mailing Address
First Line	:	1635 YALE AVE NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44703-1602
Country	:	US
Telephone Number	:	330-209-9630
Fax Number	:

Provider Business Practice Location Address
First Line	:	1635 YALE AVE NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44703-1602
Country	:	US
Telephone Number	:	330-209-9630
Fax Number	:

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

Provider Enumeration Date	:	05/13/2007
Last Update Date	:	07/09/2007

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