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General NPI Number Information
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NPI Number | 1003154519
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Entity Type | Organization
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Legal Business Name | SPINE & SPORTS MEDICINE OF BARNEGAT LLC
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Dates
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Enumeration Date | 01/18/2013
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 175 GUNNING RIVER RD BUILDING D
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City | BARNEGAT
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State | NJ
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Zip | 08005-1436
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Country | US
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Telephone | 732-714-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 175 GUNNING RIVER RD BLDG D
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City | BARNEGAT
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State | NJ
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Zip | 08005-1436
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Country | US
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Telephone | 609-660-0002
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Fax | 609-660-0003
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Authorized Official
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Title or Position | DIRECTOR/ MANAGING PARTNER
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Name | JAMES KIRK
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Credential | D.C.
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Telephone | 609-660-0002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00577500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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