Miranda Boss, DPT, ATC

NPI #1386078756 in Kewanee, Illinois

Provider Information

NPI Number: 1386078756
Entity Type: Individual
Name: Miranda Boss, DPT, ATC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: DPT, ATC
Enumeration Date: Aug 21, 2013
Last Updated: Oct 29, 2013

Practice Location

Address: 1258 W SOUTH ST
Address 2: SUITE 1
City: Kewanee
State: Illinois
ZIP Code: 61443-8300
Phone: (309) 852-2200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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