Provider Demographics
NPI:1487982963
Name:BOYCE, MICHAEL TODD (OTR/L)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:TODD
Last Name:BOYCE
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3816 CHESTNUT TRL
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-9239
Mailing Address - Country:US
Mailing Address - Phone:972-983-8392
Mailing Address - Fax:
Practice Address - Street 1:3816 CHESTNUT TRL
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-9239
Practice Address - Country:US
Practice Address - Phone:972-983-8392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111969225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist