Provider Demographics
NPI:1326664822
Name:BEARD, BOAZ B
Entity type:Individual
Prefix:
First Name:BOAZ
Middle Name:B
Last Name:BEARD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1828 S EAST LAKE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-8085
Mailing Address - Country:US
Mailing Address - Phone:316-519-4273
Mailing Address - Fax:
Practice Address - Street 1:1828 S EAST LAKE RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-8085
Practice Address - Country:US
Practice Address - Phone:316-519-4273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist