Provider Demographics
NPI:1104834290
Name:DEAN E. BOYER, D.C., P.C.
Entity Type:Organization
Organization Name:DEAN E. BOYER, D.C., P.C.
Other - Org Name:BOYER CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BOYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-473-3585
Mailing Address - Street 1:217 POINT TOWNSHIP DR
Mailing Address - Street 2:
Mailing Address - City:NORTHUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17857-8701
Mailing Address - Country:US
Mailing Address - Phone:570-473-3585
Mailing Address - Fax:570-473-7503
Practice Address - Street 1:217 POINT TOWNSHIP DR
Practice Address - Street 2:
Practice Address - City:NORTHUMBERLAND
Practice Address - State:PA
Practice Address - Zip Code:17857-8701
Practice Address - Country:US
Practice Address - Phone:570-473-3585
Practice Address - Fax:570-473-7503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003824L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016591950003Medicaid
PA0016591950003Medicaid
PAU05630Medicare UPIN