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General NPI Number Information
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NPI Number | 1801275102
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Entity Type | Organization
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Legal Business Name | RANDALL S CHALNICK DC LLC
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Dates
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Enumeration Date | 05/20/2015
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Last Update Date | 05/20/2015
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Provider Practice Location Address
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Address Line | 16 MAJESTIC DR
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City | FREEHOLD
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State | NJ
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Zip | 07728-1448
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Country | US
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Telephone | 732-239-2392
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Fax | 732-780-7232
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Provider Business Mailing Address
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Address Line | 3587 HWY 9 SUITE 222
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City | FREEHOLD
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State | NJ
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Zip | 07728-3288
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Country | US
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Telephone | 732-239-2392
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Fax | 732-780-4852
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. RANDALL S CHALNICK
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Credential | D.C.
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Telephone | 732-239-2392
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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 | 38MC00362600
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License Number State | NJ
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