Individual
LAURA N BOALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2265 PARR AVE, DYERSBURG, TN 38024-2078
(731) 285-6600
(731) 285-8005
Mailing address
2265 PARR AVE, DYERSBURG, TN 38024-2078
(731) 285-6600
(731) 285-8005
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8385
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446631
—
TN
01
—
4235349
BCBS OF TN
TN
Enumeration date
08/20/2009
Last updated
02/02/2011
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