Healthcare Provider Details

I. General information

NPI: 1639668650
Provider Name (Legal Business Name): TLB HEALTH SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2018
Last Update Date: 05/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 SANTORO CT
BRANCHBURG NJ
08876-5491
US

IV. Provider business mailing address

2 SANTORO CT
BRANCHBURG NJ
08876-5491
US

V. Phone/Fax

Practice location:
  • Phone: 732-595-5270
  • Fax: 732-595-5443
Mailing address:
  • Phone: 732-595-5270
  • Fax: 732-595-5443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number38MC00530500
License Number StateNJ

VIII. Authorized Official

Name: DR. BRENDON A BEATRICE
Title or Position: OWNER
Credential: DC
Phone: 732-595-5270