MEDICARE: DR. KAITLYN NICOLE BOYER PT, DPT

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	225100000X	Physical Therapist	1331963	TX
2	225100000X	Physical Therapist
3	2251X0800X	Orthopedic Physical Therapist	1331963	TX
4	225100000X	Physical Therapist	29194	MD

General Provider Information

NPI Number	:	1821600867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAITLYN NICOLE BOYER PT, DPT

Provider Business Mailing Address
First Line	:	2240 GREENSPRING DR
Second Line	:
City	:	TIMONIUM
State	:	MD
Zip	:	21093-3114
Country	:	US
Telephone Number	:	410-989-3833
Fax Number	:

Provider Business Practice Location Address
First Line	:	2219 BEL PRE RD
Second Line	:
City	:	ASPEN HILL
State	:	MD
Zip	:	20906-2204
Country	:	US
Telephone Number	:	443-566-4255
Fax Number	:

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

Provider Enumeration Date	:	08/20/2020
Last Update Date	:	10/19/2023

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