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General NPI Number Information
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NPI Number | 1326289489
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Entity Type | Organization
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Legal Business Name | ADVANCED FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 03/18/2009
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Last Update Date | 05/22/2009
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Provider Practice Location Address
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Address Line | 622 INMAN AVE
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City | COLONIA
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State | NJ
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Zip | 07067-1000
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Country | US
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Telephone | 732-499-9191
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Fax | 732-499-8618
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Provider Business Mailing Address
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Address Line | 35 JEFFERY RD
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City | COLONIA
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State | NJ
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Zip | 07067-2413
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Country | US
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Telephone | 732-499-9191
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Fax | 732-499-8618
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EMMA L YEPEZ
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Credential | DC
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Telephone | 732-499-9191
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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 | MC04763
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License Number State | NJ
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