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General NPI Number Information
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NPI Number | 1801931274
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Entity Type | Organization
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Legal Business Name | JERRY E. BOYER, PH.D., P.C.
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 47 CHESTNUT ST
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City | LEWISTOWN
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State | PA
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Zip | 17044-2202
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Country | US
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Telephone | 717-248-1174
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Fax | 717-248-1175
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Provider Business Mailing Address
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Address Line | PO BOX 1111
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City | LEWISTOWN
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State | PA
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Zip | 17044-3111
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Country | US
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Telephone | 717-248-1174
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Fax | 717-248-1175
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JERRY EDWIN BOYER
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Credential |
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Telephone | 717-248-1174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PS002678L
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License Number State | PA
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