| NPI | 1437359114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES EDWARD MASCENIK Director 201-420-1165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ MCO-6174) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01212100) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2007-11-08 |