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General NPI Number Information
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NPI Number | 1487012415
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Entity Type | Organization
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Legal Business Name | GLENN KNOBELMAN, D.C.LLC
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Dates
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Enumeration Date | 02/04/2016
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Last Update Date | 02/04/2016
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Provider Practice Location Address
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Address Line | 172 LANDING RD
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City | LANDING
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State | NJ
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Zip | 07850-1500
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Country | US
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Telephone | 973-398-9330
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Fax | 973-398-4552
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Provider Business Mailing Address
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Address Line | 172 LANDING RD
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City | LANDING
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State | NJ
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Zip | 07850-1500
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Country | US
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Telephone | 973-398-9330
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Fax | 973-398-4552
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Authorized Official
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Title or Position | OWNER
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Name | DR. GLENN KNOBELMAN
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Credential | D.C.
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Telephone | 973-398-9330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 38MC00154600
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License Number State | NJ
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