=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689854374
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOHN C AND MARIAN BOYE, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2007
-----------------------------------------------------
Last Update Date | 03/10/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 97829 SHOPPING CENTER AVE STE E
-----------------------------------------------------
City | BROOKINGS
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97415-9135
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-469-3446
-----------------------------------------------------
Fax | 541-469-7012
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1157
-----------------------------------------------------
City | BROOKINGS
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97415-0030
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-469-3446
-----------------------------------------------------
Fax | 541-469-7012
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SECRETARY
-----------------------------------------------------
Name | MARIAN L BOYE
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 541-469-3446
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------