Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 104353 | TX |
N | 2251E1200X | Ergonomics | 104353 | TX |
N | 225XE1200X | Ergonomics | 104353 | TX |
NPI | 1346467933 |
---|---|
Provider Name | Mr. Tim D Boezinger |
First Address | Helotes, TX 78023 |
Second Address | San Antonio, TX 78239 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 08/07/2007 |