Provider Demographics
NPI:1225190838
Name:BORGER, DONALD LUTHER (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:LUTHER
Last Name:BORGER
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 1:301 COLUMBIA ST
Mailing Address - Street 2:P.O. 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 ST
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002032L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
T28053Medicare UPIN
PA063147Medicare ID - Type Unspecified