MEDICARE: MOBILE CHIROPRACTIC CARE LLC

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	38MC00584600	NJ

General Provider Information

NPI Number	:	1932460722
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE CHIROPRACTIC CARE LLC

Provider Business Mailing Address
First Line	:	2 BRONIA ST
Second Line	:
City	:	HOWELL
State	:	NJ
Zip	:	07731-3800
Country	:	US
Telephone Number	:	973-768-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	2225 HWY 9
Second Line	:
City	:	HOWELL
State	:	NJ
Zip	:	07731-3714
Country	:	US
Telephone Number	:	973-768-5100
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	ANTHONY ADAM ROSANIA
Credential	:	DC
Telephone Number	:	973-768-5100

Provider Enumeration Date	:	06/07/2012
Last Update Date	:	06/07/2012

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