Provider Demographics
NPI:1609092030
Name:BOYER, RON DELL (DC)
Entity Type:Individual
Prefix:DR
First Name:RON
Middle Name:DELL
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 1:720 S RIVER RD STE C240
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2103
Mailing Address - Country:US
Mailing Address - Phone:435-656-2888
Mailing Address - Fax:435-656-8400
Practice Address - Street 1:720 S RIVER RD STE C240
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2103
Practice Address - Country:US
Practice Address - Phone:435-656-2888
Practice Address - Fax:435-656-8400
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2774757-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000055830Medicare ID - Type UnspecifiedCHIROPRACTIC