Healthcare Provider Details

I. General information

NPI: 1336346022
Provider Name (Legal Business Name): VELOCITY CHIROPRACTIC AND WELLNESS CENTER, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 09/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 MAPLE AVE
RED BANK NJ
07701-1727
US

IV. Provider business mailing address

231 MAPLE AVE
RED BANK NJ
07701-1727
US

V. Phone/Fax

Practice location:
  • Phone: 732-530-1164
  • Fax:
Mailing address:
  • Phone: 732-530-1164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00596000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number46TR00351500
License Number StateNJ

VIII. Authorized Official

Name: DR. JESSICA LYNN HOROWITZ
Title or Position: OWNER
Credential: D.C.
Phone: 732-530-1164