Provider Demographics
NPI:1265010722
Name:BOYKO, JOHN PAUL
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PAUL
Last Name:BOYKO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 GREEN KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-4577
Mailing Address - Country:US
Mailing Address - Phone:614-203-0620
Mailing Address - Fax:
Practice Address - Street 1:6200 BELLEFONTAINE RD
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-4009
Practice Address - Country:US
Practice Address - Phone:937-204-3095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH009325225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist