Healthcare Provider Details

I. General information

NPI: 1245559020
Provider Name (Legal Business Name): CONCORD HEALTH AND REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2010
Last Update Date: 05/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 PULASKI HWY STE 330
BEAR DE
19701-4318
US

IV. Provider business mailing address

3 HOVTECH BLVD
MOUNT LAUREL NJ
08054-6306
US

V. Phone/Fax

Practice location:
  • Phone: 302-838-2081
  • Fax: 302-838-2082
Mailing address:
  • Phone: 856-235-0202
  • Fax: 856-235-3377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. TODD BOGOS
Title or Position: OWNER
Credential: DC
Phone: 856-235-0202