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NPI Code Detail

MEDICARE: MICHAEL D BOULAY OTR/L

MEDICARE:   MICHAEL D BOULAY  OTR/L
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
1225XP0019XPhysical Rehabilitation Occupational Therapist14140MA

General Provider Information

NPI Number : 1861342339
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL D BOULAY OTR/L
Provider Business Mailing Address
First Line : 45 CARLISLE ST
Second Line :
City : WORCESTER
State : MA
Zip : 01602-3323
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 45 CARLISLE ST
Second Line :
City : WORCESTER
State : MA
Zip : 01602-3323
Country : US
Telephone Number : 774-239-0621
Fax Number : 774-239-0621
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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Directions to “ MICHAEL D BOULAY OTR/L” Practice Location

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