# EOPT BOARDMAN PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Boardman PT
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205344405
- **Authorized official:** MRS. AMANDA CARNINE PT (OWNER)
- **Authorized official phone:** (406) 531-5918

## Contact information

- **Practice address:** 101 SW KINKADE RD, BOARDMAN, OR 97818-9001
- **Practice address phone:** (541) 481-2533
- **Practice address fax:** (541) 314-4448
- **Mailing address:** PO BOX 540640, NORTH SALT LAKE, UT 84054-0640

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | OR | Yes |
| 225X00000X | Occupational Therapist | — | OR | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 01/22/2018
- **Last updated:** 11/13/2024