Basic Information
| Provider Information | |||||||||
| NPI: | 1427261353 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOYD | ||||||||
| FirstName: | KRISTY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.P.T | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1105 GARFIELD AVE | ||||||||
| Address2: | |||||||||
| City: | HAVERTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190833436 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 551 W LANCASTER AVE | ||||||||
| Address2: | |||||||||
| City: | HAVERFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190411419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105254000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT015804 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.