Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 1432 | AR |
NPI | 1174868426 |
---|---|
Provider Name | Kevin Boyles |
First Address | Arkadelphia, AR 71923-3625 |
Second Address | Arkadelphia, AR 71923-3625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2012 |
Last Update Date | 27/01/2022 |