Individual
BOYD ANDREW QUEEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
107 E MCCLANAHAN ST, OXFORD, NC 27565-2919
(919) 690-8588
(919) 603-0545
Mailing address
120 WILLIAM PENN PLZ, DURHAM, NC 27704-2150
(919) 220-5255
(919) 313-1276
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9437
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078YW
BCBSNC INDIVIDUAL PROVIDER ID NUMBER
NC
01
—
9437
NC PHYSICAL THERAPY LICENSE NUMBER
NC
Enumeration date
05/12/2006
Last updated
01/17/2012
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