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General NPI Number Information
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NPI Number | 1093076796
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Entity Type | Organization
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Legal Business Name | INTRINSIC CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 05/30/2012
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Provider Practice Location Address
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Address Line | 100 W VETERANS HWY SUITE # 7
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City | JACKSON
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State | NJ
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Zip | 08527-3435
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Country | US
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Telephone | 732-833-9000
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Fax | 732-833-9932
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Provider Business Mailing Address
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Address Line | 100 W VETERANS HWY SUITE # 7
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City | JACKSON
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State | NJ
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Zip | 08527-3435
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Country | US
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Telephone | 732-833-9000
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Fax | 732-833-9932
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Authorized Official
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Title or Position | OWNER
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Name | DR. JODI KINNEY
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Credential | D.C.
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Telephone | 732-833-9000
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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 | 38MC00571800
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License Number State | NJ
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