Provider Demographics
NPI:1699207365
Name:BORING, REBEKAH RICHARDS
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:RICHARDS
Last Name:BORING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:144 S 8TH ST STE 107
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-2752
Mailing Address - Country:US
Mailing Address - Phone:717-860-7467
Mailing Address - Fax:
Practice Address - Street 1:144 S 8TH ST STE 107
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2752
Practice Address - Country:US
Practice Address - Phone:717-414-7798
Practice Address - Fax:717-414-7842
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA116030262213E00000X
PASC007067213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist