NPI 1376153874

Derrick Boyd, PTABS

Practitioner Physical Therapy Assistant Godfrey, IL

Practice location

Address: 1373 Dadrian Professional Park, Godfrey, IL 62035-1767
Phone: (706) 261-8467
Mailing address: 1978 Oberlin Dr APT 1978, Saint Louis, MO 63146-2868

Registered specialties (2)

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 2020030538 (MO)

Other Physical Therapy Assistant providers in Illinois →

Physical Therapy Assistant

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 160.008973 (IL)

Registry record

NPI: 1376153874
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Aug 2020
Record last updated: 18 Nov 2020

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.