NPI 1033416631

Marc Boults

Practitioner Physical Therapist Brandon, FL

Practice location

Address: 602 Vonderburg Dr Suite 201, Brandon, FL 33511-5900
Phone: (863) 617-9400
Fax: (863) 688-9858

Registered specialties

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence PT 26221 (FL)

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Registry record

NPI: 1033416631
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Feb 2011
Record last updated: 17 Apr 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.