Provider Demographics
NPI:1891858353
Name:GROGIN, LAURENCE D (DC, LAC)
Entity type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:D
Last Name:GROGIN
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 FRANKLIN LAKES RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-2153
Mailing Address - Country:US
Mailing Address - Phone:201-888-4946
Mailing Address - Fax:201-847-2341
Practice Address - Street 1:936 FRANKLIN LAKES RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-1100
Practice Address - Country:US
Practice Address - Phone:201-888-4946
Practice Address - Fax:201-847-0059
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00019600171100000X
NJ38MC00222300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist