Healthcare Provider Details

I. General information

NPI: 1760841753
Provider Name (Legal Business Name): THE SPINE AND HEALTH CENTER OF MONTVALE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2016
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 PHILIPS PKWY
MONTVALE NJ
07645-1811
US

IV. Provider business mailing address

32 PHILIPS PKWY
MONTVALE NJ
07645-1811
US

V. Phone/Fax

Practice location:
  • Phone: 201-746-6577
  • Fax:
Mailing address:
  • Phone: 201-746-6577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: PETER WOHL
Title or Position: PRESIDENT
Credential: D.C.
Phone: 201-746-6577