=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679759013
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BABBITT CHIROPRACTIC CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/16/2008
-----------------------------------------------------
Last Update Date | 03/08/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 120 S MARTINE AVE
-----------------------------------------------------
City | FANWOOD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07023-1622
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-680-9600
-----------------------------------------------------
Fax | 908-680-9601
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 120 S MARTINE AVE
-----------------------------------------------------
City | FANWOOD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07023-1622
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-680-9600
-----------------------------------------------------
Fax | 908-680-9601
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER
-----------------------------------------------------
Name | DR. GRANT L BABBITT
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 908-680-9600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | MC01622
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------