Healthcare Provider Details

I. General information

NPI: 1710049564
Provider Name (Legal Business Name): BOONTON CHIROPRACTIC HEALTH CENTER,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 CORNELIA ST
BOONTON NJ
07005-1709
US

IV. Provider business mailing address

117 CORNELIA ST
BOONTON NJ
07005-1709
US

V. Phone/Fax

Practice location:
  • Phone: 973-335-5400
  • Fax: 973-335-9194
Mailing address:
  • Phone: 973-335-5400
  • Fax: 973-335-9194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number38MCO277700
License Number StateNM

VIII. Authorized Official

Name: DR. RONALD V KERN
Title or Position: CHIROPRACTOR
Credential: B.S.,D.C.
Phone: 973-335-5400