Healthcare Provider Details
I. General information
NPI: 1811132426
Provider Name (Legal Business Name): THE WASHLESKI CHIROPRACTIC CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/10/2008
Last Update Date: 12/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
179 STATE ROUTE 31 PLAZA 31
FLEMINGTON NJ
08822-5743
US
IV. Provider business mailing address
179 STATE ROUTE 31 PLAZA 31
FLEMINGTON NJ
08822-5743
US
V. Phone/Fax
- Phone: 908-806-6171
- Fax: 908-806-6433
- Phone: 908-806-6171
- Fax: 908-806-6433
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | 25MZ00006500 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NX0800X |
| Taxonomy | Orthopedic Chiropractor |
| License Number | 38MC00299200 |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
ROBERT
A
WASHLESKI
Title or Position: PRESIDENT
Credential: DC
Phone: 908-806-6171