Basic Information
| Provider Information | |||||||||
| NPI: | 1508102468 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOYDSTON | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | BRIAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 981 LOMAS SANTA FE DR | ||||||||
| Address2: | STE A | ||||||||
| City: | SOLANA BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920752144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8587949995 | ||||||||
| FaxNumber: | 8587949962 | ||||||||
| Practice Location | |||||||||
| Address1: | 981 LOMAS SANTA FE DR | ||||||||
| Address2: | STE A | ||||||||
| City: | SOLANA BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920752144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8587949995 | ||||||||
| FaxNumber: | 8587949962 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2012 | ||||||||
| LastUpdateDate: | 12/21/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 9848 | AZ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.