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General NPI Number Information
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NPI Number | 1033750369
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Entity Type | Organization
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Legal Business Name | ABSOLUTE CHIROPRACTIC & PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 10/08/2019
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Last Update Date | 10/08/2019
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Provider Practice Location Address
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Address Line | 157 PROSPECT ST
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City | PASSAIC
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State | NJ
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Zip | 07055-5128
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Country | US
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Telephone | 973-473-1550
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Fax |
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Provider Business Mailing Address
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Address Line | 65 PRINCESS DR
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-4104
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Country | US
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Telephone | 908-370-4538
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. JOSEPH MAZZEO III
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Credential | DC
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Telephone | 908-370-4538
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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 |
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License Number State |
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