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General NPI Number Information
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NPI Number | 1225373103
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Entity Type | Organization
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Legal Business Name | PRINCETON FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 12/04/2012
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Last Update Date | 12/04/2012
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Provider Practice Location Address
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Address Line | 66 MOUNT LUCAS RD SUITE E2
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City | PRINCETON
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State | NJ
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Zip | 08540-2733
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Country | US
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Telephone | 609-924-4469
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Fax | 609-228-6666
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Provider Business Mailing Address
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Address Line | PO BOX 1494
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City | PRINCETON
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State | NJ
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Zip | 08542-1494
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Country | US
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Telephone | 609-924-4469
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Fax | 609-228-6666
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL LIO
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Credential | D.C.
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Telephone | 609-924-4469
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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 | MC04091
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License Number State | NJ
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