Healthcare Provider Details

I. General information

NPI: 1700959699
Provider Name (Legal Business Name): CENTER FOR NATURAL HEALTH AND REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1386 US HWY 22 WEST
LEBANON NJ
08833
US

IV. Provider business mailing address

1386 US HWY 22 WEST
LEBANON NJ
08833
US

V. Phone/Fax

Practice location:
  • Phone: 908-236-6353
  • Fax: 908-236-7038
Mailing address:
  • Phone: 908-236-6353
  • Fax: 908-236-7038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JODY LAWRENCE SERRA
Title or Position: DIRECTOR
Credential: DC
Phone: 908-236-6353