Provider Demographics
NPI:1174036461
Name:GENESIS CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:GENESIS CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:VOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-876-9188
Mailing Address - Street 1:59 E MILL RD STE 3-102
Mailing Address - Street 2:
Mailing Address - City:LONG VALLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07853-6215
Mailing Address - Country:US
Mailing Address - Phone:908-876-9188
Mailing Address - Fax:908-876-4174
Practice Address - Street 1:59 E MILL RD STE 3-102
Practice Address - Street 2:
Practice Address - City:LONG VALLEY
Practice Address - State:NJ
Practice Address - Zip Code:07853-6215
Practice Address - Country:US
Practice Address - Phone:908-876-9188
Practice Address - Fax:908-876-4174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty