Boomer, Lois
Boomer, Lois is an individual health care provider with primary practice located at 336 S 10Th St , Montrose CO 81401-4934. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Boomer, Lois can be contacted via phone (970) 249-1412.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | 105065-4201 | Utah |
Profile Details
| NPI number | 1679629034 |
|---|---|
| LBN Legal business name | Boomer, Lois |
| Credentials | Occupational Therapist (OT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2007 |
| Last updated | Jul 12th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679629034 | NPPES |
| Utah | MEDICAID | 999000021033 D1240 |
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