IndividualActive
Boston Devore, PTA
NPI 1821836768 · Physical Therapy Assistant · Glasgow, KY
Provider details
- NPI number
- 1821836768
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PTA
- Sex
- Male
- Sole proprietor
- No
- License
- A04587 (KY)
Mailing address
3637 Bridgeport Rd
Edmonton, KY 42129-8466
Registry dates
- Enumerated
- 2024-07-16
- Last updated
- 2024-07-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.