Provider Demographics
NPI:1245449420
Name:BORIS, PAUL ANDREW (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ANDREW
Last Name:BORIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:146 MOTORDROME ROAD
Mailing Address - Street 2:
Mailing Address - City:SMITHTON
Mailing Address - State:PA
Mailing Address - Zip Code:15479-0443
Mailing Address - Country:US
Mailing Address - Phone:724-872-0200
Mailing Address - Fax:724-872-2312
Practice Address - Street 1:146 MOTORDROME ROAD
Practice Address - Street 2:
Practice Address - City:SMITHTON
Practice Address - State:PA
Practice Address - Zip Code:15479-0443
Practice Address - Country:US
Practice Address - Phone:724-872-0200
Practice Address - Fax:724-872-2312
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007565L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation