| NPI | 1891333431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP PETRIS Chiropractor/Owner 732-678-6785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 111NP0017X Chiropractor, Pediatric Chiropractor |
| 111NS0005X Chiropractor, Sports Physician | |
| 111NX0800X Chiropractor, Orthopedic | |
| Enumeration Date | 2019-12-13 |
| Last Update Date | 2019-12-13 |