Provider Demographics
NPI:1912608787
Name:BOYKO, VERA (PT, DPT)
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:BOYKO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 MALTMAN DR
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5184
Mailing Address - Country:US
Mailing Address - Phone:530-272-7306
Mailing Address - Fax:530-272-7316
Practice Address - Street 1:715 MALTMAN DR
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5184
Practice Address - Country:US
Practice Address - Phone:530-272-7306
Practice Address - Fax:530-272-7316
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA304388225100000X
IN225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist