Provider Demographics
NPI:1326168667
Name:BOYD, KIM MARIE (BS, MPT, DPT)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:MARIE
Last Name:BOYD
Suffix:
Gender:F
Credentials:BS, MPT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6128 HEARTHSTONE DR
Mailing Address - Street 2:
Mailing Address - City:PIPERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18947-1065
Mailing Address - Country:US
Mailing Address - Phone:215-766-0129
Mailing Address - Fax:
Practice Address - Street 1:2450 JOHN FRIES HWY
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-2259
Practice Address - Country:US
Practice Address - Phone:215-536-0770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008918L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist