Basic Information
| Provider Information | |||||||||
| NPI: | 1376053116 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOYLAND | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | ALEKSANDER | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1216 ORCHARD PARK RD | ||||||||
| Address2: | |||||||||
| City: | WEST SENECA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142243920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4438311736 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9475 DEERECO RD STE 102 | ||||||||
| Address2: | |||||||||
| City: | TIMONIUM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210932124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103083543 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2017 | ||||||||
| LastUpdateDate: | 03/27/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 26642 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.