Healthcare Provider Details

I. General information

NPI: 1285058990
Provider Name (Legal Business Name): MAXIMUM HEALTH & WELLNESS WOODBRIDGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 US HIGHWAY 1 S
ISELIN NJ
08830-3152
US

IV. Provider business mailing address

PO BOX 459
RARITAN NJ
08869-0459
US

V. Phone/Fax

Practice location:
  • Phone: 352-678-3092
  • Fax: 352-515-0042
Mailing address:
  • Phone: 732-582-6910
  • Fax: 352-515-0042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER CARROLL
Title or Position: OFFICE REP
Credential:
Phone: 352-678-3092