Healthcare Provider Details

I. General information

NPI: 1679417489
Provider Name (Legal Business Name): ALT SPINAL HEALTH & REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1369 SOUTH AVE
PLAINFIELD NJ
07062-1990
US

IV. Provider business mailing address

1369 SOUTH AVE
PLAINFIELD NJ
07062-1990
US

V. Phone/Fax

Practice location:
  • Phone: 732-355-5076
  • Fax: 732-554-8468
Mailing address:
  • Phone: 732-355-5076
  • Fax: 732-554-8468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY TIRRO
Title or Position: OWNER
Credential: DPT, PT
Phone: 718-619-7051