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Individual
TIFFANY BOULWARE
Active
Individual
TIFFANY BOULWARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1145779
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1145779
STATE OF TEXAS
TX
Enumeration date
11/08/2006
Last updated
10/22/2023
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