Sabina Jolanta Boies

Individual provider Active NPI Physical Therapy Assistant · Midway, UT

NPI 1386017945 · NPPES record last updated Nov 4, 2015

Key facts

NPI
1386017945
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
11375A (AZ)
Practice address
1420 W Geneva Dr
Midway, UT 84049
Phone
(847) 638-0639
NPI assigned
Nov 4, 2015
Sex
Female
Sole proprietor
No

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
11375AAZMDPhysical Therapy Assistant
160.006231ILMDPhysical Therapy Assistant
8719908-2402UTMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 11375A AZ Yes
Physical Therapy Assistant 225200000X 8719908-2402 UT
Physical Therapy Assistant 225200000X 160.006231 IL

Addresses

Primary practice location

1420 W Geneva Dr
Midway, UT 84049

Mailing address

PO Box 814
1420 W Geneva Dr
Midway, UT 84049
Phone (847) 638-0639

Other names

  • Sabina Jolanta Moniuszko Former name

Other providers in Midway, UT

All providers in Midway, UT · Physical Therapy Assistant in Utah

Sources for this page

Verify at the official NPI Registry.