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General NPI Number Information
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NPI Number | 1760492573
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Entity Type | Organization
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Legal Business Name | DHCC,LLC
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 08/08/2012
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Provider Practice Location Address
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Address Line | 2800 ROUTE 130 N SUITE 200
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City | CINNAMINSON
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State | NJ
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Zip | 08077-3035
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Country | US
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Telephone | 856-786-2600
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Fax | 856-786-2601
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Provider Business Mailing Address
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Address Line | 2800 ROUTE 130 N
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City | CINNAMINSON
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State | NJ
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Zip | 08077-3035
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Country | US
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Telephone | 856-786-2600
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Fax | 856-786-2601
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Authorized Official
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Title or Position | OWNER
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Name | TODD BOGOS
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Credential | D.C
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Telephone | 856-786-2600
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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 | 38MC00553800
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License Number State | NJ
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