Healthcare Provider Details

I. General information

NPI: 1609497833
Provider Name (Legal Business Name): GARCIA FAMILY & SPORTS CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2020
Last Update Date: 05/29/2020
Certification Date: 05/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 CENTRAL AVE STE 2
WESTFIELD NJ
07090
US

IV. Provider business mailing address

812 CENTRAL AVE STE 2
WESTFIELD NJ
07090
US

V. Phone/Fax

Practice location:
  • Phone: 908-654-9228
  • Fax:
Mailing address:
  • Phone: 908-654-9228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. RENE JOHN GARCIA
Title or Position: OWNER
Credential: DC
Phone: 512-694-5415