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Individual

MARVIN R. BOREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
4642 HILLS DALES RD NW, CANTON, OH 44708-1510
(330) 477-4400
Mailing address
4642 HILLS DALES RD NW, CANTON, OH 44708
(330) 477-4400

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36001949
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0433169
OH
Enumeration date
11/08/2005
Last updated
01/09/2008
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