Individual
MR. BRAD BOYLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2491
OR
2255A2300X
Athletic Trainer
AT-AT-183301
OR
Other
Enumeration date
03/16/2007
Last updated
09/11/2025
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