Provider Demographics
NPI:1023992922
Name:SUNDEEN, BODEN (DC)
Entity type:Individual
Prefix:DR
First Name:BODEN
Middle Name:
Last Name:SUNDEEN
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 1:4480 DUBLIN RD APT 1
Mailing Address - Street 2:
Mailing Address - City:MARCELLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13108-1018
Mailing Address - Country:US
Mailing Address - Phone:518-764-2569
Mailing Address - Fax:
Practice Address - Street 1:29 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-4069
Practice Address - Country:US
Practice Address - Phone:315-857-5501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013961111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor