Provider Demographics
NPI:1184950305
Name:BOYS, PAUL DAVID (PT)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:DAVID
Last Name:BOYS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4555 LAKE FOREST DR
Mailing Address - Street 2:STE 150
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-3781
Mailing Address - Country:US
Mailing Address - Phone:877-327-2278
Mailing Address - Fax:888-322-2278
Practice Address - Street 1:4555 LAKE FOREST DR
Practice Address - Street 2:STE 150
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-3781
Practice Address - Country:US
Practice Address - Phone:877-327-2278
Practice Address - Fax:888-322-2278
Is Sole Proprietor?:No
Enumeration Date:2009-10-22
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-009990225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200983990Medicaid
OH3032220Medicaid
IN200983990Medicaid