Provider Demographics
NPI:1407027865
Name:BORER, ROBERT C III (DC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:C
Last Name:BORER
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1327
Mailing Address - Country:US
Mailing Address - Phone:734-944-7200
Mailing Address - Fax:734-944-8070
Practice Address - Street 1:210 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1327
Practice Address - Country:US
Practice Address - Phone:734-944-7200
Practice Address - Fax:734-944-8070
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-13
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007974111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION18580Medicare PIN