Provider Demographics
NPI:1154833093
Name:ADVANCED CHIROPRACTIC HEALTHCARE & WELLNESS, LLC
Entity Type:Organization
Organization Name:ADVANCED CHIROPRACTIC HEALTHCARE & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:WANDERSON
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:848-456-4782
Mailing Address - Street 1:613 HOPE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-1279
Mailing Address - Country:US
Mailing Address - Phone:848-456-4782
Mailing Address - Fax:
Practice Address - Street 1:613 HOPE RD STE 1
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-1279
Practice Address - Country:US
Practice Address - Phone:848-456-4782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center