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General NPI Number Information
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NPI Number | 1023282845
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Entity Type | Organization
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Legal Business Name | NEMIROFF CHIROPRACTIC ADVANTAGE CENTERS PC
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 10/17/2008
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Provider Practice Location Address
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Address Line | 1430 HOOPER AVE 203
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City | TOMS RIVER
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State | NJ
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Zip | 08753-2895
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Country | US
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Telephone | 723-244-5340
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Fax | 732-244-5369
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Provider Business Mailing Address
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Address Line | 1430 HOOPER AVE 203
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City | TOMS RIVER
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State | NJ
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Zip | 08753-2895
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Country | US
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Telephone | 723-244-5340
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Fax | 732-244-5369
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Authorized Official
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Title or Position | OWNER
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Name | DR. LANCE A NEMIROFF
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Credential | DC
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Telephone | 732-244-5340
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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 | 00573600
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License Number State | NJ
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