Provider Demographics
NPI:1649354283
Name:BOYLAN & BUREK CHIROPRACTIC, PC
Entity type:Organization
Organization Name:BOYLAN & BUREK CHIROPRACTIC, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARYANN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-670-6333
Mailing Address - Street 1:367 W PENN AVE
Mailing Address - Street 2:
Mailing Address - City:WERNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19565-1413
Mailing Address - Country:US
Mailing Address - Phone:610-670-6333
Mailing Address - Fax:610-670-8730
Practice Address - Street 1:367 W PENN AVE
Practice Address - Street 2:
Practice Address - City:WERNERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19565-1413
Practice Address - Country:US
Practice Address - Phone:610-670-6333
Practice Address - Fax:610-670-8730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0398649000OtherHMO ID #
PA000955399OtherHIGHMARK BLUE SHEILD ID