Provider Demographics
NPI:1881826824
Name:BOYD, ANITA (DPT)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:11490 ALPHARETTA HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-3811
Practice Address - Country:US
Practice Address - Phone:770-740-8592
Practice Address - Fax:770-752-9478
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT9663225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist