Provider Demographics
NPI:1306962022
Name:BOYD, TAMARA SUZANNE (DC)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:SUZANNE
Last Name:BOYD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 114
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:CO
Mailing Address - Zip Code:80435-0114
Mailing Address - Country:US
Mailing Address - Phone:970-668-8008
Mailing Address - Fax:970-668-8009
Practice Address - Street 1:325 LAKE DILLON DRIVE
Practice Address - Street 2:#204
Practice Address - City:DILLON
Practice Address - State:CO
Practice Address - Zip Code:80435
Practice Address - Country:US
Practice Address - Phone:970-668-8008
Practice Address - Fax:970-668-8009
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor