| Mr Charles Holloway Boardman Iv, OTR | |
|
619 South Marion Ave, North Florida / South Georgia Veterans Health System, Lake City, FL 32025 | |
| (386) 755-3016 | |
| Not Available |
| Full Name | Mr Charles Holloway Boardman Iv |
|---|---|
| Gender | Male |
| Speciality | Occupational Therapist |
| Location | 619 South Marion Ave, Lake City, Florida |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164417895 | NPI | - | NPPES |
| OT14416FL | Other | FL | FLORIDA DEPARTMENT OF HEALTH |
| AA499343 | Other | NBCOT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | OT14416FL (Florida) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Charles Holloway Boardman Iv, OTR 355 Sw Sweetbreeze Dr, Lake City, FL 32024-3698 Ph: (386) 755-3016 | Mr Charles Holloway Boardman Iv, OTR 619 South Marion Ave, North Florida / South Georgia Veterans Health System, Lake City, FL 32025 Ph: (386) 755-3016 |
Mary Ann Di Lillo, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 619 S Marion Ave, Lake City, FL 32025 Phone: 386-755-3016 | |
Morgan Murphy, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 298 Sw Prosperity Pl, Lake City, FL 32024 Phone: 386-269-3900 | |
Seema Kunder, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 659 Sw Dexter Cir, Apt 105, Lake City, FL 32025 Phone: 386-344-3807 | |
Ms. Taisha D Brown, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 560 Sw Mcfarlane Ave, Lake City, FL 32025 Phone: 386-758-4777 | |
Jasmin Henry-fuller, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 229 Sw Main Blvd, Lake City, FL 32025 Phone: 386-515-3009 | |
Miss Armenthis Youhon Lester, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 619 S Marion Ave, Lake City, FL 32025 Phone: 386-755-3016 |