Individual provider · Type 1 NPI

Charles Holloway Boardman Iv, OTR

Occupational Therapist · Lake City, FL

NPI number 1164417895 Active

Practice location

619 South Marion Ave, North Florida / South Georgia Veterans Health System
Lake City, FL 32025

Call (386) 755-3016 Map

Mailing address

355 SW Sweetbreeze Dr
Lake City, FL 32024-3698

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapist Primary 225X00000XOT14416FL (FL)

Occupational Therapist: An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork…

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About NPI 1164417895

Charles Holloway Boardman Iv, OTR's National Provider Identifier is 1164417895, issued on Sep 19, 2005. The primary taxonomy on file is Occupational Therapist (225X00000X), and the practice location is in Lake City, FL. The record was last updated on Feb 25, 2012.