Provider Demographics
NPI:1811959877
Name:BOYLAN, MARK E (DC)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:E
Last Name:BOYLAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:316 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-4246
Mailing Address - Country:US
Mailing Address - Phone:407-886-2299
Mailing Address - Fax:407-886-1227
Practice Address - Street 1:333 W MAIN ST
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-3451
Practice Address - Country:US
Practice Address - Phone:407-886-2299
Practice Address - Fax:407-886-1227
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003217111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor