Healthcare Provider Details

I. General information

NPI: 1255353090
Provider Name (Legal Business Name): DENVILLE CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 E MAIN ST
DENVILLE NJ
07834-2647
US

IV. Provider business mailing address

161 E MAIN ST
DENVILLE NJ
07834-2647
US

V. Phone/Fax

Practice location:
  • Phone: 973-627-7888
  • Fax: 973-627-7040
Mailing address:
  • Phone: 973-627-7888
  • Fax: 973-627-7040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberMC00378100
License Number StateNJ

VIII. Authorized Official

Name: DR. DAVID BARRETT III
Title or Position: OWNER
Credential: DC
Phone: 973-627-7888