Provider Demographics
NPI:1912608787
Name:BOYKO, VERA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:BOYKO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13252 COUNTY ROAD 4
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:IN
Mailing Address - Zip Code:46540-8300
Mailing Address - Country:US
Mailing Address - Phone:910-320-1222
Mailing Address - Fax:
Practice Address - Street 1:800 JASMINE ST
Practice Address - Street 2:
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841-9501
Practice Address - Country:US
Practice Address - Phone:509-826-7666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist