Provider Demographics
NPI:1255589818
Name:BOARDMAN, DANA PAUL (KINESIOTHERAPIST)
Entity type:Individual
Prefix:MR
First Name:DANA
Middle Name:PAUL
Last Name:BOARDMAN
Suffix:
Gender:M
Credentials:KINESIOTHERAPIST
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Mailing Address - Street 1:28 OAKDALE ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-3317
Mailing Address - Country:US
Mailing Address - Phone:774-826-2134
Mailing Address - Fax:774-826-2585
Practice Address - Street 1:940 BELMONT ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-5596
Practice Address - Country:US
Practice Address - Phone:774-826-2134
Practice Address - Fax:774-826-2585
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist