Provider Demographics
NPI:1932381282
Name:BOYLE, LANIE MICHELE (PT)
Entity Type:Individual
Prefix:MRS
First Name:LANIE
Middle Name:MICHELE
Last Name:BOYLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 CASTLEMAINE DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35226-5913
Mailing Address - Country:US
Mailing Address - Phone:337-739-6760
Mailing Address - Fax:
Practice Address - Street 1:909 CASTLEMAINE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35226-5913
Practice Address - Country:US
Practice Address - Phone:337-739-6760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26949225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51545527OtherBCBS