Provider Demographics
NPI:1912240102
Name:BOAS FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:BOAS FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-591-2580
Mailing Address - Street 1:479 ROUTE 79 STE 15
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-4088
Mailing Address - Country:US
Mailing Address - Phone:732-591-2580
Mailing Address - Fax:732-591-1525
Practice Address - Street 1:479 ROUTE 79 STE 15
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-4088
Practice Address - Country:US
Practice Address - Phone:732-591-2580
Practice Address - Fax:732-591-1525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00647000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty