MS. CAROL DIANE BOULWARE (NPI# 1275781643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275781643 |
| Entity Type | Individual |
| Full Name | MS. CAROL DIANE BOULWARE |
| Credential | LMT |
| Practice Address |
1615 Spruce St Quincy IL 62301-2060 |
| Practice Telephone | 2172423495 |
| Mailing Telephone | 2172423495 |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2008-08-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 2005038798 | MO | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407925480 | Carol Boulware | Marriage & Family Therapist | 3130 Wilshire Blvd, 550, Santa Monica, CA 90403-2346 | 2006-11-06 |
| Street Address |
1615 SPRUCE ST |
| City | QUINCY |
| State | IL |
| Zip Code | 62301-2060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356969471 | Lutheran Child and Family Service of Illinois | Foster Care Agency | 1400 N. 30th St, Quincy, IL 62301 | 2020-07-07 |
| 1134749716 | Bethany Nicole Jumps | Pharmacist | Broadway St & N 11th St, Quincy, IL 62301 | 2020-04-23 |
| 1043844293 | S.crider Construction An Supply Corp. | Contractor | 529 Woodbridge Dr., Quincy, IL 62301 | 2020-02-26 |
| 1245862002 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 3301 Broadway St., Quincy, IL 62301 | 2020-02-10 |
| 1043851488 | West Central Illinois Nutrition | In Home Supportive Care | 639 York St. Room 333, Quincy, IL 62301 | 2019-10-07 |
| 1861986549 | Quincy Physicians & Surgeons Clinic, Sc | Internal Medicine | 3347 Broadway St, Quincy, IL 62301 | 2018-06-18 |
| 1194255083 | Michael Andrew Behrens | Nurse Practitioner | Broadway and 11th Street, Quincy, IL 62301 | 2017-06-14 |
| 1770987323 | Kirsty Yvonne Reed | Counselor | 205 S. 24th Street, Chaddock, Quincy, IL 62301 | 2014-10-10 |
| 1114234499 | Dale D. Shahan Dds Ltd | Dentist | 636 Hampshire Suite 102, Quincy, IL 62301 | 2010-09-08 |
| 1730314071 | James D Kaufmann | Pharmacist | 14th & Broadway, Quincy, IL 62301 | 2009-05-15 |
| Find all providers in zip 62301 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558806513 | Karla Daniela Morga | Massage Therapist | 21 D St. Sw, Suite B3, Quincy, WA 98848 | 2016-12-30 |
| 1548617178 | Nicole's Healing Hands Massage | Massage Therapist | 21 D St Sw Ste B3, Quincy, WA 98848-1236 | 2016-05-24 |
| 1558629311 | Waiman Lo | Massage Therapist | 1458 Hancock St Ste 220, Quincy, MA 02169-5214 | 2012-04-30 |
| 1609170968 | Aimee Marie Lutz | Massage Therapist | 110 C St Sw, Quincy, WA 98848-1207 | 2010-12-30 |
| 1629398375 | Katarzyna Anna Ginter | Massage Therapist | 15 Harvard St, Quincy, MA 02171-2813 | 2010-06-04 |
| 1487982013 | Kimarie Massage School | Massage Therapist | 319 Newport Ave, Quincy, MA 02170-1726 | 2009-11-19 |
| 1871722934 | Shun Yee Tang | Massage Therapist | 1431 Hancock St Ste 2f, Thai Massage and Acupuncture, Quincy, MA 02169-5217 | 2009-07-10 |
| 1558598748 | Li Yan Qin | Massage Therapist | 1431 Hancock St, 2 Floor, Thai Massage and Acupuncture, Quincy, MA 02169 | 2009-06-16 |
| 1669606059 | Ping Ping Wong | Massage Therapist | 329a Newport Ave, Quincy, MA 02170-1726 | 2009-05-13 |
| 1710106646 | Nicole Lynn O'shea | Massage Therapist | 311 Central Ave S, Quincy, WA 98848-1227 | 2007-04-25 |
| Find all providers in QUINCY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.