Healthcare Provider Details

I. General information

NPI: 1386722635
Provider Name (Legal Business Name): CHRISTINE L. PROBE DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 02/07/2020
Certification Date: 02/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 MANTUA PIKE
WOODBURY HEIGHTS NJ
08097-1149
US

IV. Provider business mailing address

740 MANTUA PIKE
WOODBURY HEIGHTS NJ
08097-1149
US

V. Phone/Fax

Practice location:
  • Phone: 856-845-0360
  • Fax:
Mailing address:
  • Phone: 856-845-0360
  • Fax: 856-845-1881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00263400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: