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General NPI Number Information
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NPI Number | 1831623941
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Entity Type | Organization
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Legal Business Name | TENSION AND TRAUMA RELIEF, LLC
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Dates
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Enumeration Date | 04/14/2017
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Last Update Date | 04/14/2017
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Provider Practice Location Address
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Address Line | 55 W SOMERSET ST SUITE 2REAR
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City | RARITAN
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State | NJ
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Zip | 08869-2026
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Country | US
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Telephone | 973-534-8089
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Fax | 908-725-2453
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Provider Business Mailing Address
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Address Line | 55 W SOMERSET ST SUITE 2REAR
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City | RARITAN
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State | NJ
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Zip | 08869-2026
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Country | US
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Telephone | 973-534-8089
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Fax | 908-725-2453
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | DR. MICHAEL MANGINELLI, DC, MS, MBA
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Credential | DC
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Telephone | 973-534-8089
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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 | 3167
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License Number State | NJ
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