Individual
MR. JERRY EDWIN BOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
47 CHESTNUT ST, LEWISTOWN, PA 17044-2202
(717) 248-1174
(717) 248-1175
Mailing address
PO BOX 1111, LEWISTOWN, PA 17044-3111
(717) 248-1174
(717) 248-1175
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PS002678L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03106101
CBC PRACTITIONER ID
PA
01
—
338947
VALUE OPTIONS
PA
Enumeration date
02/21/2007
Last updated
07/08/2007
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