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General NPI Number Information
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NPI Number | 1790904860
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Entity Type | Organization
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Legal Business Name | HELLER FAMILY CHIROPRACTIC PC
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 03/14/2013
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Provider Practice Location Address
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Address Line | 725 RIVER RD THE MARKETPLACE #55
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City | EDGEWATER
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State | NJ
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Zip | 07020-1171
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Country | US
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Telephone | 201-606-6006
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Fax |
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Provider Business Mailing Address
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Address Line | 725 RIVER RD THE MARKETPLACE #55
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City | EDGEWATER
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State | NJ
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Zip | 07020-1171
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Country | US
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Telephone | 201-606-6006
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN HELLER
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Credential | D.C
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Telephone | 201-606-6006
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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 |
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License Number State |
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