Healthcare Provider Details

I. General information

NPI: 1073577763
Provider Name (Legal Business Name): MARIAN L BOYE DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 08/27/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97829 SHOPPING CENTER AVE STE F
BROOKINGS OR
97415-9135
US

IV. Provider business mailing address

PO BOX 1157
BROOKINGS OR
97415-0030
US

V. Phone/Fax

Practice location:
  • Phone: 541-469-3446
  • Fax: 541-469-7012
Mailing address:
  • Phone: 541-469-3446
  • Fax: 541-469-7012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1298
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: