| NPI | 1336656461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAN SIVENDRA Managing Member 908-325-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2018-01-10 |