MEDICARE: CHIROPRACTORS ON THE MOVE, LLP

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	MC 05659	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5043	OTHER	GA	GA LICENSE
2	X009747	OTHER	NY	NY LICENSE
3	CH6617	OTHER	FL	FL LICENSE
4	MC 05659	OTHER	NJ	NJ LICENSE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982822524
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTORS ON THE MOVE, LLP

Provider Business Mailing Address
First Line	:	50 HIGHTSTOWN RD
Second Line	:	SUITE D
City	:	PRINCETON JUNCTION
State	:	NJ
Zip	:	08550-1107
Country	:	US
Telephone Number	:	609-897-1200
Fax Number	:	609-897-0900

Provider Business Practice Location Address
First Line	:	50 HIGHTSTOWN RD
Second Line	:	SUITE D
City	:	PRINCETON JUNCTION
State	:	NJ
Zip	:	08550-1107
Country	:	US
Telephone Number	:	609-897-1200
Fax Number	:	609-897-0900

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARK DEITCH
Credential	:	DC
Telephone Number	:	609-897-1200

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	08/22/2020

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