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NPI Code Detail

MEDICARE: AMY C BOYER MPT, MAED, ATC

MEDICARE: AMY C BOYER MPT, MAED, ATC
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
1225100000XPhysical Therapist2305203760VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00258650OTHERVAMEDICARE PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3175787OTHERVAANTHEM SERVICES
43123773OTHERVAMAMSI

General Provider Information

NPI Number : 1326011594
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY C BOYER MPT, MAED, ATC
Provider Business Mailing Address
First Line : 504 ALBEMARLE SQ
Second Line :
City : CHARLOTTESVILLE
State : VA
Zip : 22901-7405
Country : US
Telephone Number : 434-817-7848
Fax Number : 434-465-6834
Provider Business Practice Location Address
First Line : 111 MONTICELLO AVE STE B
Second Line :
City : CHARLOTTESVILLE
State : VA
Zip : 22902-5698
Country : US
Telephone Number : 434-817-4276
Fax Number : 434-465-6836
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2006
Last Update Date : 05/04/2023

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