Individual
CLYDE FRANCIS BOISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, OCS
Contact information
Practice address
29650 BRADLEY RD, SUN CITY, CA 92586-6521
(951) 672-0455
Mailing address
29650 BRADLEY RD, SUN CITY, CA 92586-6521
(951) 672-0455
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 23165
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PT0147050
—
CA
Enumeration date
06/03/2006
Last updated
07/09/2007
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