Healthcare Provider Details

I. General information

NPI: 1326233859
Provider Name (Legal Business Name): CHIROPRACTIC WELLNESS CENTER OF CLIFTON, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 BROAD ST STE 4
CLIFTON NJ
07013-4201
US

IV. Provider business mailing address

1425 BROAD ST STE 4
CLIFTON NJ
07013-4201
US

V. Phone/Fax

Practice location:
  • Phone: 973-773-8244
  • Fax: 973-591-0474
Mailing address:
  • Phone: 973-773-8244
  • Fax: 973-591-0474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL R. MAGWOOD
Title or Position: PRESIDENT
Credential: DC
Phone: 973-773-8244