Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC002032L | PA |
NPI | 1225190838 |
---|---|
Provider Name | Dr. Donald Luther Borger |
First Address | Schuylkill Haven, PA 17972-0097 |
Second Address | Schuylkill Haven, PA 17972-0097 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T28053 | (02) |