| NPI | 1568052132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH LICITRA Managing Member 973-470-0632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NI0013X Chiropractor, Independent Medical Examiner |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2021-01-19 |