Provider Demographics
NPI:1033379847
Name:DAVID A. BOVE, ND PC
Entity Type:Organization
Organization Name:DAVID A. BOVE, ND PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOVE
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:541-683-2126
Mailing Address - Street 1:1161 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3417
Mailing Address - Country:US
Mailing Address - Phone:541-683-2126
Mailing Address - Fax:
Practice Address - Street 1:1161 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3417
Practice Address - Country:US
Practice Address - Phone:541-683-2126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR227955OtherOMAP