Individual
MR. KEVIN C BORING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
155 RESTON PLACE, GASSAWAY, WV 26624
(304) 364-9191
(304) 364-9193
Mailing address
155 RESTON PLACE, GASSAWAY, WV 26624
(304) 364-9191
(304) 364-9193
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
001248
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0157029000
—
WV
Enumeration date
08/19/2006
Last updated
09/29/2015
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