Provider Demographics
NPI:1144818949
Name:BOYNTON, MARK (DC)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:BOYNTON
Suffix:
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 1:1641 VENTURE DR STE C
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-7001
Mailing Address - Country:US
Mailing Address - Phone:740-397-1212
Mailing Address - Fax:
Practice Address - Street 1:1641 VENTURE DR STE C
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-7001
Practice Address - Country:US
Practice Address - Phone:614-397-1212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05047111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor