Provider Demographics
NPI:1285961698
Name:BOYD, REGINA (PTA)
Entity type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MS
Other - First Name:REGINA
Other - Middle Name:
Other - Last Name:TRAJKOV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2092 OSPREY DR
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-9242
Mailing Address - Country:US
Mailing Address - Phone:586-246-7857
Mailing Address - Fax:
Practice Address - Street 1:35746 HARPER AVE
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-3212
Practice Address - Country:US
Practice Address - Phone:586-791-9203
Practice Address - Fax:586-791-9204
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant