Provider Demographics
NPI:1093935439
Name:BOYER, JOANN (CPHT)
Entity Type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:
Last Name:BOYER
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 290
Mailing Address - Street 2:23123 30TH STREET
Mailing Address - City:GOBLES
Mailing Address - State:MI
Mailing Address - Zip Code:49055-0290
Mailing Address - Country:US
Mailing Address - Phone:269-628-6046
Mailing Address - Fax:
Practice Address - Street 1:206 S. STATE STREET
Practice Address - Street 2:
Practice Address - City:GOBLES
Practice Address - State:MI
Practice Address - Zip Code:49055-0290
Practice Address - Country:US
Practice Address - Phone:269-628-2650
Practice Address - Fax:269-628-4022
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other