Healthcare Provider Details
I. General information
NPI: 1003455643
Provider Name (Legal Business Name): BALANCED BODY CHIROPRACTIC HEALTHCARE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/30/2019
Last Update Date: 12/30/2019
Certification Date: 12/30/2019
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6 FOREST AVE STE 215
PARAMUS NJ
07652-5241
US
IV. Provider business mailing address
6 FOREST AVE STE 215
PARAMUS NJ
07652-5241
US
V. Phone/Fax
- Phone: 201-880-5145
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CAREY
SKORSKI
Title or Position: PRESIDENT
Credential: DC
Phone: 917-288-0014