Provider Demographics
NPI:1841468303
Name:GARY A. BORING D.C.
Entity type:Organization
Organization Name:GARY A. BORING D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:BORING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-353-9040
Mailing Address - Street 1:12626 E 40 HWY
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-5944
Mailing Address - Country:US
Mailing Address - Phone:816-353-9040
Mailing Address - Fax:816-353-0091
Practice Address - Street 1:12626 E 40 HWY
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-5944
Practice Address - Country:US
Practice Address - Phone:816-353-9040
Practice Address - Fax:816-353-0091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-18
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO003430111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T73627Medicare UPIN
0002719Medicare PIN