Derrick Boyd, PTA, BS

Physical Therapy Assistant · Godfrey, IL

Individual Active NPI

NPI number 1376153874

Practice location

1373 Dadrian Professional Park
Godfrey, IL 62035-1767
Phone
(706) 261-8467

Open in Google Maps

NPI record

NPI
1376153874
Entity type
Individual (Type 1)
Enumeration date
August 9, 2020
Last updated
November 18, 2020
Certified
November 18, 2020
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physical Therapy Assistant Primary 225200000X 2020030538 MO
Physical Therapy Assistant 225200000X 160.008973 IL

Mailing address

1978 Oberlin Dr Apt 1978
Saint Louis, MO 63146-2868
Phone
(618) 292-7886

About Derrick Boyd

Derrick Boyd, PTA, BS is a healthcare provider registered in the NPI registry with the primary taxonomy Physical Therapy Assistant (code 225200000X). The practice location is 1373 Dadrian Professional Park, Godfrey, IL 62035-1767. The NPI number 1376153874 was assigned on August 9, 2020 and the record was last updated on November 18, 2020.

Derrick Boyd lists 2 licenses in the registry: #2020030538 (MO) for Physical Therapy Assistant; #160.008973 (IL) for Physical Therapy Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Derrick Boyd, PTA, BS?

The NPI number is 1376153874.

What is the phone number of Derrick Boyd?

The phone number listed for the practice location is (706) 261-8467.

Where is Derrick Boyd located?

1373 Dadrian Professional Park, Godfrey, IL 62035-1767.

What is the taxonomy code for Derrick Boyd?

The primary taxonomy code is 225200000X – Physical Therapy Assistant; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

Other Physical Therapy Assistant providers in Godfrey

All Physical Therapy Assistant providers in Godfrey, IL →