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General NPI Number Information
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NPI Number | 1003081514
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Entity Type | Organization
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Legal Business Name | MADALIAN CHIROPRACTIC & PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 04/25/2008
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Last Update Date | 06/06/2008
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Provider Practice Location Address
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Address Line | 573 VALLEY RD SUITE 3
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City | WAYNE
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State | NJ
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Zip | 07470-3511
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Country | US
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Telephone | 973-633-0117
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Fax |
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Provider Business Mailing Address
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Address Line | 573 VALLEY RD SUITE 3
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City | WAYNE
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State | NJ
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Zip | 07470-3511
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Country | US
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Telephone | 973-633-0117
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HENRY MADALIAN
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Credential | DC
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Telephone | 973-633-1757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 03475
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License Number State | NJ
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