| NPI | 1407272453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WALTER DIMARCO Owner 732-665-6334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00709900) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01539300) |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2014-11-10 |