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NPI Code Detail

MEDICARE: DR. KENDRA F. BOELL D.O.

MEDICARE:  DR. KENDRA F. BOELL  D.O.
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
1207Q00000XFamily Medicine PhysicianOS011210LPA

General Provider Information

NPI Number : 1306811617
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENDRA F. BOELL D.O.
Provider Business Mailing Address
First Line : 100 N ACADEMY AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17822-3034
Country : US
Telephone Number : 570-271-6144
Fax Number : 570-271-6578
Provider Business Practice Location Address
First Line : 100 N ACADEMY AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17822-2111
Country : US
Telephone Number : 570-271-6439
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2006
Last Update Date : 07/08/2007

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Directions to “ DR. KENDRA F. BOELL D.O.” Practice Location

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