Provider Demographics
NPI:1215231972
Name:DR. DONALD L. BORGER
Entity Type:Organization
Organization Name:DR. DONALD L. BORGER
Other - Org Name:HAVEN CHIROPRACTIC CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:LUTHER
Authorized Official - Last Name:BORGER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:570-385-2322
Mailing Address - Street 1:301 COLUMBIA STREET
Mailing Address - Street 2:PO BOX 97
Mailing Address - City:SCHUYLKILL HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17972-0097
Mailing Address - Country:US
Mailing Address - Phone:570-385-2322
Mailing Address - Fax:570-385-7246
Practice Address - Street 1:301 COLUMBIA STREET
Practice Address - Street 2:
Practice Address - City:SCHUYLKILL HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17972-0097
Practice Address - Country:US
Practice Address - Phone:570-385-2322
Practice Address - Fax:570-385-7246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010365111N00000X
PADC002032L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty