Organization
GASTON REHAB ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN JOSEPH BOYLE DPT (PRESIDENT, PHYSICAL THERAPIST)
(704) 864-4424
Entity
Organization
Contact information
Practice address
1385 E GARRISON BLVD, GASTONIA, NC 28054-5127
(704) 864-4424
(704) 864-2125
Mailing address
1385 E GARRISON BLVD, GASTONIA, NC 28054-5127
(704) 864-4424
(704) 864-2125
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
8975
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078V2
BLUE CROSS BLUE SHIELD
NC
01
—
3484600
AETNA HMO
NC
05
—
7211587
—
NC
01
—
7559538
AETNA PPO/POS
NC
01
—
D3291
MEDCOST
NC
Enumeration date
07/26/2005
Last updated
10/08/2012
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