Organization
JUSTIN BOYCE P.C.
Active
Organization
JUSTIN BOYCE P.C.
Active
Other names
diversey health center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN BENNETT BOYCE D.C. (PRESIDENT)
(773) 472-7484
Entity
Organization
Contact information
Practice address
757 W DIVERSEY PKWY, CHICAGO, IL 60614-6505
(773) 472-7484
(773) 472-6716
Mailing address
757 W DIVERSEY PKWY, CHICAGO, IL 60614-6505
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
038010051
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1616934
BCBS PROVIDER NUMBER
IL
Enumeration date
02/06/2007
Last updated
08/30/2010
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