| NPI | 1902349152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK FERGUSON Owner 973-559-1212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38mc00674100) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00351100) |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2016-11-21 |