Healthcare Provider Details

I. General information

NPI: 1093476640
Provider Name (Legal Business Name): DEVIN R KARL DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2022
Last Update Date: 01/05/2022
Certification Date: 01/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 ALLWOOD RD
CLIFTON NJ
07012-1941
US

IV. Provider business mailing address

925 ALLWOOD RD
CLIFTON NJ
07012-1941
US

V. Phone/Fax

Practice location:
  • Phone: 973-473-4481
  • Fax: 973-473-8852
Mailing address:
  • Phone: 973-473-4481
  • Fax: 973-473-8852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00787100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: