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General NPI Number Information
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NPI Number | 1457002776
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Entity Type | Organization
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Legal Business Name | STRUCTURAL HEALTH LLC
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 870 POMPTON AVE STE A1
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City | CEDAR GROVE
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State | NJ
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Zip | 07009-1203
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Country | US
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Telephone | 973-534-1401
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Fax |
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Provider Business Mailing Address
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Address Line | 870 POMPTON AVE STE A1
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City | CEDAR GROVE
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State | NJ
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Zip | 07009-1203
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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 | GLENN SORRENTINO
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Credential |
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Telephone | 973-534-1401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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