Individual
TRAVIS RYAN BOYETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
4016 N 78TH ST, SCOTTSDALE, AZ 85251-4640
(480) 246-4040
Mailing address
4016 N 78TH ST, SCOTTSDALE, AZ 85251-4640
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2607
GA
225X00000X
Occupational Therapist
Primary
3402
AZ
225X00000X
Occupational Therapist
9576
MA
Other
Enumeration date
12/17/2006
Last updated
12/09/2008
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