| NPI | 1073699385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS DANDREA President 732-345-1377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00516600) |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2006-10-29 |
| Last Update Date | 2012-02-20 |