NPI | 1770914012 |
---|---|
Doing Business As | 360 SPINE & SPORT |
Entity Type | Organization |
Authorized Contact | MARK BENCIVENGO Chiropractor/Owner 609-587-1881 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00700500) |
Enumeration Date | 2013-12-12 |
Last Update Date | 2020-10-07 |