Healthcare Provider Details

I. General information

NPI: 1225190838
Provider Name (Legal Business Name): DONALD LUTHER BORGER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 COLUMBIA ST
SCHUYLKILL HAVEN PA
17972-0097
US

IV. Provider business mailing address

301 COLUMBIA ST P.O. BOX 97
SCHUYLKILL HAVEN PA
17972-0097
US

V. Phone/Fax

Practice location:
  • Phone: 570-385-2322
  • Fax: 570-385-7246
Mailing address:
  • Phone: 570-385-2322
  • Fax: 570-385-7246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC002032L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: