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General NPI Number Information
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NPI Number | 1205091618
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Entity Type | Organization
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Legal Business Name | SUMMIT SPINE & SPORT, LLC
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Dates
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Enumeration Date | 07/24/2008
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 12 JAMES ST
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City | MORRISTOWN
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State | NJ
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Zip | 07960-5942
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Country | US
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Telephone | 973-285-0888
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Fax |
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Provider Business Mailing Address
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Address Line | 15 SUSSEX CT
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City | BEDMINSTER
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State | NJ
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Zip | 07921-1833
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CLIFFORD DAUB
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Credential | D.C.
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Telephone | 908-451-5641
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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 | MC05176
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License Number State | NJ
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