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General NPI Number Information
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NPI Number | 1023551769
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Entity Type | Organization
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Legal Business Name | KANE FAMILY CHIROPRACTIC PC
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Dates
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Enumeration Date | 11/29/2016
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Last Update Date | 12/06/2016
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Provider Practice Location Address
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Address Line | 1361 FAIRVIEW BLVD SUITE H
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City | DELRAN
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State | NJ
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Zip | 08075-1473
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Country | US
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Telephone | 856-544-3585
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Fax | 856-544-3586
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Provider Business Mailing Address
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Address Line | 1361 FAIRVIEW BLVD SUITE H
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City | DELRAN
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State | NJ
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Zip | 08075-1473
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Country | US
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Telephone | 856-544-3585
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Fax | 856-544-3586
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JACQUELYN MARIA KANE
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Credential | DC
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Telephone | 856-544-3585
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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 | 38MC00725100
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License Number State | NJ
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