# PATRICK T BOYLAN MD INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake Physical Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760884399
- **Authorized official:** DR. PATRICK T BOYLAN MD (OWNER / PHYSICIAN)
- **Authorized official phone:** (440) 205-9119

## Contact information

- **Practice address:** 9485 MENTOR AVE STE 203, MENTOR, OH 44060-8723
- **Practice address phone:** (440) 205-9119
- **Mailing address:** 9485 MENTOR AVE STE 203, MENTOR, OH 44060-8723
- **Mailing address phone:** (440) 205-9119
- **Mailing address fax:** (440) 205-9209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 35072046 | OH | Yes |

## Other

- **Enumeration date:** 09/26/2014
- **Last updated:** 03/02/2020