OrganizationActive
Boardman Health and Wellness, PLLC
NPI 1063453363 · Physician Assistant · S Boardman, MI
Provider details
- NPI number
- 1063453363
- Entity type
- Organization
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Thomas Stetler, Officer(231) 369-2656
- License
- 4301069428 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4713 Pine St Sw
S Boardman, MI 49680-9761
Phone: (231) 369-2656
Street-level locationGet directions
Mailing address
4713 Pine St Sw
S Boardman, MI 49680-9761
Registry dates
- Enumerated
- 2006-06-09
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.