Provider Demographics
NPI:1578361648
Name:BOONE, ERIC
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:BOONE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 SETTLEMENT DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-9155
Mailing Address - Country:US
Mailing Address - Phone:309-620-1589
Mailing Address - Fax:
Practice Address - Street 1:501 PINNER WEALD WAY STE 102
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2610
Practice Address - Country:US
Practice Address - Phone:919-466-9494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist