Provider Demographics
NPI:1790242972
Name:KIRKLAND-BOYCE, ELIJAH AKEEM
Entity Type:Individual
Prefix:
First Name:ELIJAH
Middle Name:AKEEM
Last Name:KIRKLAND-BOYCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 E SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-3665
Mailing Address - Country:US
Mailing Address - Phone:412-224-8246
Mailing Address - Fax:
Practice Address - Street 1:237 E SUMMIT ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-3665
Practice Address - Country:US
Practice Address - Phone:412-224-8246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer