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General NPI Number Information
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NPI Number | 1841300019
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Entity Type | Individual
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Provider Name | DANIEL BERNARD JUNIOR III D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 472 RIDGEDALE AVE
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City | EAST HANOVER
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State | NJ
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Zip | 07936-3064
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Country | US
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Telephone | 973-884-1111
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Fax | 973-884-3605
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Provider Business Mailing Address
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Address Line | 27 SPRINGBROOK RD W
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City | MONTVILLE
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State | NJ
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Zip | 07045-9136
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Country | US
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Telephone | 973-334-5558
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Fax | 973-884-3605
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MC05894
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License Number State | NJ
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