Provider Demographics
NPI:1548563398
Name:MICHAEL W. GOLZ, D.C., LLC
Entity Type:Organization
Organization Name:MICHAEL W. GOLZ, D.C., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:GOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-891-6100
Mailing Address - Street 1:719 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-1920
Mailing Address - Country:US
Mailing Address - Phone:201-891-6100
Mailing Address - Fax:201-848-8863
Practice Address - Street 1:719 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-1920
Practice Address - Country:US
Practice Address - Phone:201-891-6100
Practice Address - Fax:201-848-8863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00313700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty