Healthcare Provider Details

I. General information

NPI: 1598952384
Provider Name (Legal Business Name): FAMILY HEALTH CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2007
Last Update Date: 09/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 MALL BLVD
BRUNSWICK GA
31525-0539
US

IV. Provider business mailing address

712 MALL BLVD
BRUNSWICK GA
31525-0539
US

V. Phone/Fax

Practice location:
  • Phone: 912-264-1806
  • Fax: 912-264-1808
Mailing address:
  • Phone: 912-264-1806
  • Fax: 912-264-1808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID C. BOCZAR
Title or Position: OWNER
Credential: DC
Phone: 912-264-1806