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General NPI Number Information
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NPI Number | 1356595110
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Entity Type | Organization
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Legal Business Name | BACK & NECK CARE CENTER, P.C.
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Dates
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Enumeration Date | 11/06/2008
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Last Update Date | 11/06/2008
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Provider Practice Location Address
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Address Line | 1082 SAINT GEORGES AVE
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City | RAHWAY
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State | NJ
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Zip | 07065-2664
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Country | US
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Telephone | 732-388-4787
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Fax | 732-388-4380
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Provider Business Mailing Address
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Address Line | 1082 SAINT GEORGES AVE
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City | RAHWAY
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State | NJ
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Zip | 07065-2664
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Country | US
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Telephone | 732-388-4787
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Fax | 732-388-4380
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | MR. MARK ZIENTEK
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Credential | D.C.
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Telephone | 732-388-4787
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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 | NJ2736
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License Number State | NJ
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