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NPI Code Detail

MEDICARE: AMMIE LEE BOYD LMT

MEDICARE: AMMIE LEE BOYD LMT
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
1225700000XMassage Therapist11492OR

General Provider Information

NPI Number : 1346573755
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMMIE LEE BOYD LMT
Provider Business Mailing Address
First Line : 400 EAST MAIN STREET
Second Line : SUITE 180
City : HILLSBORO
State : OR
Zip : 97123-4161
Country : US
Telephone Number : 503-681-8125
Fax Number : 503-368-1873
Provider Business Practice Location Address
First Line : 400 EAST MAIN STREET
Second Line : SUITE 180
City : HILLSBORO
State : OR
Zip : 97123-4161
Country : US
Telephone Number : 503-681-8125
Fax Number : 503-368-1873
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2009
Last Update Date : 09/16/2009

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