Healthcare Provider Details

I. General information

NPI: 1841755360
Provider Name (Legal Business Name): ERMANN CHIROPRACTIC & WELLNESS CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2019
Last Update Date: 02/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 CEDAR LN STE 1
TEANECK NJ
07666-3442
US

IV. Provider business mailing address

315 CEDAR LN STE 1
TEANECK NJ
07666-3442
US

V. Phone/Fax

Practice location:
  • Phone: 201-836-1900
  • Fax: 201-836-4502
Mailing address:
  • Phone: 201-836-1900
  • Fax: 201-836-4502

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

VIII. Authorized Official

Name: KENNETH M ERMANN
Title or Position: OWNER
Credential: DC
Phone: 201-836-1900