Provider Demographics
NPI:1417044652
Name:BOECK CHIROPRACTIC CLINIC, PA
Entity type:Organization
Organization Name:BOECK CHIROPRACTIC CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BOECK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:252-634-3111
Mailing Address - Street 1:2602 NEUSE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-2846
Mailing Address - Country:US
Mailing Address - Phone:252-634-3111
Mailing Address - Fax:252-634-3040
Practice Address - Street 1:2602 NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2846
Practice Address - Country:US
Practice Address - Phone:252-634-3111
Practice Address - Fax:252-634-3040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2434111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty