Healthcare Provider Details

I. General information

NPI: 1073420881
Provider Name (Legal Business Name): DOMINION HEALTH AND INJURY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8998 NJ-18 SUITE 215
OLD BRIDGE NJ
08857
US

IV. Provider business mailing address

976 PRESIDENTIAL BLVD APT 6
TOMS RIVER NJ
08753-6558
US

V. Phone/Fax

Practice location:
  • Phone: 617-543-4917
  • Fax:
Mailing address:
  • Phone: 617-543-4917
  • Fax: 617-543-4917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. CHUKWUDI NWBUNWANNE ONWUAKOR
Title or Position: MANAGING MEMBER
Credential: DC
Phone: 617-543-4917