Kimberly Sue Boozell, LPTA

Individual provider Active NPI Physical Therapy Assistant · Johnstown, OH

NPI 1104902410 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104902410
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA 05449 (OH)
Practice address
32 S Main St
Johnstown, OH 43031-1225
Phone
(740) 967-0303
Fax
(740) 967-2332
NPI assigned
Oct 29, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA 05449OHMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Johnstown Physical Therapy Physical Therapy Assistant Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA 05449 OH Yes

Addresses

Primary practice location

32 S Main St
Johnstown, OH 43031-1225

Mailing address

10853 Lafayette Rd
Johnstown, OH 43031-9396
Phone (740) 334-1395

Other providers in Johnstown, OH

All providers in Johnstown, OH · Physical Therapy Assistant in Ohio

Sources for this page

Verify at the official NPI Registry.