MEDICARE: PLUMSTED CHIROPRACTIC CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	MC3753	NJ

General Provider Information

NPI Number	:	1639336811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLUMSTED CHIROPRACTIC CENTER

Provider Business Mailing Address
First Line	:	609 ROUTE 539
Second Line	:
City	:	CREAM RIDGE
State	:	NJ
Zip	:	08514-2334
Country	:	US
Telephone Number	:	609-758-2900
Fax Number	:

Provider Business Practice Location Address
First Line	:	609 ROUTE 539
Second Line	:
City	:	CREAM RIDGE
State	:	NJ
Zip	:	08514-2334
Country	:	US
Telephone Number	:	609-758-2900
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL R TAPIA
Credential	:	D.C
Telephone Number	:	609-758-2900

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	05/16/2008

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