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General NPI Number Information
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NPI Number | 1003187154
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Entity Type | Organization
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Legal Business Name | LAUCK CHIROPRACTIC HEALTH CENTER INC.
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Dates
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Enumeration Date | 01/21/2012
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Last Update Date | 01/21/2012
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Provider Practice Location Address
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Address Line | 740 MILFORD WARREN GLEN RD
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City | MILFORD
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State | NJ
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Zip | 08848-1647
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Country | US
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Telephone | 908-995-0777
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Fax | 908-995-0778
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Provider Business Mailing Address
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Address Line | 740 MILFORD WARREN GLEN RD
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City | MILFORD
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State | NJ
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Zip | 08848-1647
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Country | US
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Telephone | 908-995-0777
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Fax | 908-995-0778
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES F. LAUCK II
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Credential | D.C.
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Telephone | 908-995-0777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00506500
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License Number State | NJ
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