Healthcare Provider Details

I. General information

NPI: 1700479060
Provider Name (Legal Business Name): GREGORY HOUCK DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2021
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1603 OXMEAD RD
BURLINGTON NJ
08016-4215
US

IV. Provider business mailing address

1603 OXMEAD RD
BURLINGTON NJ
08016-4215
US

V. Phone/Fax

Practice location:
  • Phone: 609-386-6100
  • Fax: 609-386-2838
Mailing address:
  • Phone: 609-386-6100
  • Fax: 609-386-2838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number013427
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number011685
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00794900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: