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General NPI Number Information
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NPI Number | 1467642108
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Entity Type | Organization
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Legal Business Name | THE CHIROPRACTIC CENTER AT STYERTOWNE, LLC
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Dates
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Enumeration Date | 07/30/2007
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 501 ALLWOOD RD
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City | CLIFTON
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State | NJ
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Zip | 07012-2160
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Country | US
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Telephone | 973-777-6995
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Fax |
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Provider Business Mailing Address
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Address Line | 501 ALLWOOD RD
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City | CLIFTON
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State | NJ
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Zip | 07012-2160
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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 | MEMBER/DIRECTOR
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Name | JACQUELINE PAZ
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Credential | DC
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Telephone | 973-777-6995
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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 | 38MC00576900
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License Number State | NJ
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