Provider Demographics
NPI:1639380173
Name:BOYLE, ALICE ANN (PTA)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:ANN
Last Name:BOYLE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 COAL HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:SARVER
Mailing Address - State:PA
Mailing Address - Zip Code:16055
Mailing Address - Country:US
Mailing Address - Phone:724-353-0031
Mailing Address - Fax:724-353-0031
Practice Address - Street 1:1301 CARLISLE ST
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065
Practice Address - Country:US
Practice Address - Phone:724-226-7302
Practice Address - Fax:724-226-7252
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE001074L225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant