Provider Demographics
NPI:1043505803
Name:ACCUTRITION NUTRITIONAL CONSULTANTS, INC
Entity Type:Organization
Organization Name:ACCUTRITION NUTRITIONAL CONSULTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:O'KEEFE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-654-7500
Mailing Address - Street 1:99 TAUNTON RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-9362
Mailing Address - Country:US
Mailing Address - Phone:609-654-7500
Mailing Address - Fax:609-654-7505
Practice Address - Street 1:99 TAUNTON RD
Practice Address - Street 2:SUITE 103
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-9362
Practice Address - Country:US
Practice Address - Phone:609-654-7500
Practice Address - Fax:609-654-7505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00182800111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ192249MEOMedicare PIN