Boardsen, Bryan

Boardsen, Bryan is an individual health care provider with primary practice located at 815 W Tower Park Dr , Waterloo IA 50701-9026. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as his primary health care specialty. Boardsen, Bryan can be contacted via phone (319) 233-6995.

Contact Information

Primary practice address
815 W Tower Park Dr Waterloo IA 50701-9026
Phone: (319) 233-6995
Fax: (319) 233-7083
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 056-008438 Illinois
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 002042 Iowa

Profile Details

NPI number 1700036043
LBN Legal business name Boardsen, Bryan
Credentials MOT
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2008
Last updated Apr 11th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700036043 NPPES
Iowa Other 002042 IOWA PT LICENSE NUMBER

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