Boertje, Mark
Boertje, Mark is an sole proprietor health care provider with primary practice located at 3700 S High St Suite 95, Columbus OH 43207-4083. He recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as his primary health care specialty. Boertje, Mark can be contacted via phone (740) 815-3391.Contact Information
Primary practice address
3700 S High St Suite 95
Columbus OH 43207-4083
Phone: (740) 815-3391
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X | CC1003049 | Ohio |
Profile Details
| NPI number | 1811394174 |
|---|---|
| LBN Legal business name | Boertje, Mark |
| Credentials | ED.S, NCSP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 1st, 2014 |
| Last updated | Dec 1st, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811394174 | NPPES |
| Ohio | Other | CC1003049 | OHIO DEPARTMENT OF EDUCATION |
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