Breanna G Boaz, PTA
Physical Therapy Assistant in Black Mountain, NC. Individual provider (NPI-1).
NPI number1053136366
StatusActive
Last updated in NPPESNov 21, 2024
Details
- NPI
- 1053136366
- Entity type
- Individual (NPI-1)
- Name
- Breanna G Boaz
- Credential
- PTA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 21, 2024
- Certification date
- Nov 21, 2024
- Last updated
- Nov 21, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | A7984 | NC | Yes |
Practice location
200 Tabernacle RdBlack Mountain, NC 28711-7733
Phone 828-357-3611
Mailing address
478 N Fork RdBlack Mountain, NC 28711-8762
Phone 828-279-8279
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