Provider Demographics
NPI:1710288667
Name:BOSS, CYNTHIA A
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:BOSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 104
Mailing Address - Street 2:
Mailing Address - City:EAST TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02718-0104
Mailing Address - Country:US
Mailing Address - Phone:508-884-8979
Mailing Address - Fax:
Practice Address - Street 1:175 MIDDLEBORO AVE
Practice Address - Street 2:
Practice Address - City:EAST TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02718-1019
Practice Address - Country:US
Practice Address - Phone:508-884-8979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2330225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant