| NPI | 1306500061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK FERGUSON Owner 201-716-9199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2021-10-28 |