MEDICARE: MARIAN L BOYE DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1298	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	014146000	OTHER	BX
3	P00004353	OTHER	RR MC B

General Provider Information

NPI Number	:	1073577763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAN L BOYE DC

Provider Business Mailing Address
First Line	:	PO BOX 1157
Second Line	:
City	:	BROOKINGS
State	:	OR
Zip	:	97415-0030
Country	:	US
Telephone Number	:	541-469-3446
Fax Number	:	541-469-7012

Provider Business Practice Location Address
First Line	:	97829 SHOPPING CENTER AVE STE F
Second Line	:
City	:	BROOKINGS
State	:	OR
Zip	:	97415-9135
Country	:	US
Telephone Number	:	541-469-3446
Fax Number	:	541-469-7012

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	08/27/2020

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Directions to “ MARIAN L BOYE DC” Practice Location

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