Provider Demographics
NPI:1942216411
Name:AYD-BOYD, PATRICIA O'BRIEN (MPT)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:O'BRIEN
Last Name:AYD-BOYD
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 DAYLONG LN
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1626
Mailing Address - Country:US
Mailing Address - Phone:410-988-9466
Mailing Address - Fax:410-988-9447
Practice Address - Street 1:6100 DAYLONG LN
Practice Address - Street 2:SUITE 203
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1626
Practice Address - Country:US
Practice Address - Phone:410-988-9466
Practice Address - Fax:410-988-9447
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20795225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD216532Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER