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General NPI Number Information
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NPI Number | 1376282574
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Entity Type | Organization
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Legal Business Name | MONMOUTH SPINE AND WELLNESS II
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Dates
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Enumeration Date | 06/03/2022
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Last Update Date | 06/03/2022
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Provider Practice Location Address
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Address Line | 1503 SAINT GEORGES AVE STE 101
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City | COLONIA
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State | NJ
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Zip | 07067-3427
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Country | US
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Telephone | 732-943-2637
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Fax | 732-943-2745
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Provider Business Mailing Address
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Address Line | 342 ROUTE 9 STE 1
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City | MANALAPAN
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State | NJ
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Zip | 07726-9603
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Country | US
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Telephone | 732-252-5555
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Fax | 723-252-5512
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Authorized Official
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Title or Position | MEMBER/CHIROPRACTIC PHYSICIAN
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Name | DR. RACQUEL GABRIELLA DECARO
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Credential | DC
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Telephone | 917-916-5217
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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 |
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License Number State |
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