Provider Demographics
NPI:1720033533
Name:BOYCE, DAVID A (PT, OCS, ECS, EDD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:BOYCE
Suffix:
Gender:M
Credentials:PT, OCS, ECS, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 ZARING MILL CIRCLE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-3052
Mailing Address - Country:US
Mailing Address - Phone:502-454-5544
Mailing Address - Fax:502-454-5562
Practice Address - Street 1:3052 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3020
Practice Address - Country:US
Practice Address - Phone:502-454-5544
Practice Address - Fax:502-454-5562
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPT001844225100000X, 2251E1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50012586OtherPASSPORT
KYP00820915OtherMEDICARE RAILROAD CARRIER
KY710077620Medicaid
KY710077620Medicaid