Provider Demographics
NPI:1114913399
Name:BOYER, DEAN E (DC)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:E
Last Name:BOYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003824L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016591950003Medicaid
PA1417619OtherCHIROPRACTIC
PA001712Medicare ID - Type Unspecified
PA1417619OtherCHIROPRACTIC