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General NPI Number Information
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NPI Number | 1063943892
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Entity Type | Organization
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Legal Business Name | JUSTIN BOYCE, P.C.
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Dates
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Enumeration Date | 03/23/2017
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Last Update Date | 03/23/2017
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Provider Practice Location Address
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Address Line | 114 W CALENDAR AVE SUITE A
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City | LA GRANGE
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State | IL
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Zip | 60525-2601
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Country | US
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Telephone | 708-308-4585
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Fax |
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Provider Business Mailing Address
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Address Line | 114 W CALENDAR AVE SUITE A
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City | LA GRANGE
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State | IL
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Zip | 60525-2601
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Country | US
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Telephone | 708-308-4585
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JUSTIN BOYCE
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Credential | D.C.
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Telephone | 708-308-4585
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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 | 038-010051
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111NP0017X
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Taxonomy Name | Pediatric Chiropractor
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License Number | 038-010420
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038-010420
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License Number State | IL
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