| NPI | 1184996332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD M VERNON Medical Director 201-420-1165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-02-03 |