Provider Demographics
NPI:1497277685
Name:BOYD, DENISE E (PT)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:E
Last Name:BOYD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:SEMRAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 TAHOMA BLVD UNIT 207
Practice Address - Street 2:
Practice Address - City:YELM
Practice Address - State:WA
Practice Address - Zip Code:98597-7735
Practice Address - Country:US
Practice Address - Phone:360-458-6400
Practice Address - Fax:360-458-6444
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH225100000X
OR63433225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist