Provider Demographics
NPI:1619251048
Name:BOE, CAROL L (MS, CES)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:L
Last Name:BOE
Suffix:
Gender:F
Credentials:MS, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 W BELTLINE HWY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-2318
Mailing Address - Country:US
Mailing Address - Phone:608-417-7305
Mailing Address - Fax:608-417-5770
Practice Address - Street 1:2501 W BELTLINE HWY
Practice Address - Street 2:SUITE 207
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-2318
Practice Address - Country:US
Practice Address - Phone:608-417-7305
Practice Address - Fax:608-417-5770
Is Sole Proprietor?:No
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist