MEDICARE: CHIROPRACTIC AND REHAB EXERCISE CENTER OF SOUTH JERSEY, AC, L.L.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	AHL2812927	NJ
2	171100000X	Acupuncturist	25MZ00032700	NJ
3	225100000X	Physical Therapist	40QA00696200	NJ
4	111N00000X	Chiropractor	MC005068	NJ

General Provider Information

NPI Number	:	1710219654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC AND REHAB EXERCISE CENTER OF SOUTH JERSEY, AC, L.L.C

Provider Business Mailing Address
First Line	:	4712 VENTNOR AVE
Second Line	:
City	:	ATLANTIC CITY
State	:	NJ
Zip	:	08401-5654
Country	:	US
Telephone Number	:	609-344-3123
Fax Number	:

Provider Business Practice Location Address
First Line	:	4712 VENTNOR AVE
Second Line	:
City	:	ATLANTIC CITY
State	:	NJ
Zip	:	08401-5654
Country	:	US
Telephone Number	:	609-344-3123
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MEMBER
Name	:	DR. STEVE APITCHED ALBERTI
Credential	:	D.C.
Telephone Number	:	609-922-2456

Provider Enumeration Date	:	02/03/2010
Last Update Date	:	02/03/2010

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