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General NPI Number Information
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NPI Number | 1073886602
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Entity Type | Organization
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Legal Business Name | DR, THEODORE HILLER
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Dates
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Enumeration Date | 02/13/2012
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 764 EASTON AVE
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City | SOMERSET
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State | NJ
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Zip | 08873-1856
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Country | US
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Telephone | 732-846-8060
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Fax | 732-846-0233
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Provider Business Mailing Address
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Address Line | 764 EASTON AVE
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City | SOMERSET
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State | NJ
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Zip | 08873-1856
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Country | US
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Telephone | 732-846-8060
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Fax | 732-846-0233
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Authorized Official
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Title or Position | CORPORATION
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Name | DR. THEODORE J HILLER
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Credential | D.C. P.A.
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Telephone | 732-846-8069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 38MC06321600
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License Number State | NJ
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