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General NPI Number Information
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NPI Number | 1821439282
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Entity Type | Organization
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Legal Business Name | ESSENTIAL HEALTH LLC
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 01/15/2014
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Provider Practice Location Address
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Address Line | 480 MEMORIAL PKWY
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865-1575
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Country | US
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Telephone | 908-454-8808
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Fax | 908-998-4762
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Provider Business Mailing Address
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Address Line | 480 MEMORIAL PKWY
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865-1575
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Country | US
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Telephone | 908-454-8808
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Fax | 908-998-4762
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Authorized Official
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Title or Position | OWNER
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Name | JAMES W. MATTISON JR.
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Credential | D.C.
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Telephone | 908-454-8808
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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 | 38MC00514100
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License Number State | NJ
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