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NPI Code Detail

MEDICARE: KELLY BOYLE

MEDICARE:   KELLY  BOYLE
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
1225X00000XOccupational TherapistOT18074CA

General Provider Information

NPI Number : 1295242261
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY BOYLE
Provider Business Mailing Address
First Line : 328 ELIOT LN
Second Line :
City : LONG BEACH
State : CA
Zip : 90814-3117
Country : US
Telephone Number : 720-218-5838
Fax Number :
Provider Business Practice Location Address
First Line : 328 ELIOT LN
Second Line :
City : LONG BEACH
State : CA
Zip : 90814-3117
Country : US
Telephone Number : 720-218-5838
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2017
Last Update Date : 03/12/2025

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Directions to “ KELLY BOYLE ” Practice Location

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