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General NPI Number Information
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NPI Number | 1780116335
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Entity Type | Organization
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Legal Business Name | BOYER CHIROPRACTIC AND WELLNESS CENTER PC
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 215 SOUTH LYTLE STREET
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City | ELDERTON
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State | PA
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Zip | 15736-0236
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Country | US
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Telephone | 724-354-2617
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Fax | 724-354-2703
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Provider Business Mailing Address
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Address Line | PO BOX 236
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City | ELDERTON
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State | PA
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Zip | 15736-0236
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Country | US
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Telephone | 724-354-2617
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Fax | 724-354-2703
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. JAMIE BOYER
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Credential | DC
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Telephone | 724-354-2617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC009067
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License Number State | PA
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