Provider Demographics
NPI:1700064706
Name:HYATT BOYD, CHRISTINE BURTON (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:BURTON
Last Name:HYATT BOYD
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 MIRA MAR AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8546
Mailing Address - Country:US
Mailing Address - Phone:541-857-7033
Mailing Address - Fax:541-857-7714
Practice Address - Street 1:1200 MIRA MAR AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8546
Practice Address - Country:US
Practice Address - Phone:541-857-7033
Practice Address - Fax:541-857-7714
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2003225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist