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General NPI Number Information
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NPI Number | 1003153586
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Entity Type | Organization
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Legal Business Name | FREEHOLD SPINE ASSOCIATES
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Dates
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Enumeration Date | 01/03/2013
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Last Update Date | 01/03/2013
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Provider Practice Location Address
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Address Line | 100 PROFESSIONAL VIEW DRIVE SUITE 103
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City | FREEHOLD
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State | NJ
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Zip | 07728-2526
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Country | US
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Telephone | 732-431-6674
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Fax |
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Provider Business Mailing Address
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Address Line | 100 PROFESSIONAL VIEW DRIVE SUITE 103
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City | FREEHOLD
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State | NJ
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Zip | 07728-2526
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Country | US
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Telephone | 732-431-6674
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTPR
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Name | RICHARD RYAN
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Credential | D.C
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Telephone | 732-780-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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