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Individual

KYLE W BOREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1420 TUSCULUM BLVD FL 4, GREENEVILLE, TN 37745-4279
(423) 639-2103
(423) 783-5515
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
3143
TN
390200000X
Student in an Organized Health Care Education/Training Program
33
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q025878
TN
Enumeration date
08/11/2011
Last updated
02/26/2024
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