Provider Demographics
NPI:1689854374
Name:JOHN C AND MARIAN BOYE, PC
Entity Type:Organization
Organization Name:JOHN C AND MARIAN BOYE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOYE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-469-3446
Mailing Address - Street 1:PO BOX 1157
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:OR
Mailing Address - Zip Code:97415-0030
Mailing Address - Country:US
Mailing Address - Phone:541-469-3446
Mailing Address - Fax:541-469-7012
Practice Address - Street 1:97829 SHOPPING CENTER AVE
Practice Address - Street 2:STE E
Practice Address - City:BROOKINGS
Practice Address - State:OR
Practice Address - Zip Code:97415-9135
Practice Address - Country:US
Practice Address - Phone:541-469-3446
Practice Address - Fax:541-469-7012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR0000WFBFZMedicare PIN