Healthcare Provider Details

I. General information

NPI: 1760429351
Provider Name (Legal Business Name): SHARI L SALUCK D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 04/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 A HADDON AVE.
WESTMONT NJ
08108
US

IV. Provider business mailing address

340 A HADDON AVE.
WESTMONT NJ
08108
US

V. Phone/Fax

Practice location:
  • Phone: 856-833-9390
  • Fax:
Mailing address:
  • Phone: 856-833-9390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberMC004990
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: