Provider Demographics
NPI:1225240468
Name:CHIRO PARTNERS LLC
Entity Type:Organization
Organization Name:CHIRO PARTNERS LLC
Other - Org Name:LIFESTYLE CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:TAMBURELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-255-8000
Mailing Address - Street 1:1868 HOOPER AVENUE
Mailing Address - Street 2:UNIT #6
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753
Mailing Address - Country:US
Mailing Address - Phone:732-255-8000
Mailing Address - Fax:732-255-4580
Practice Address - Street 1:1868 HOOPER AVENUE
Practice Address - Street 2:UNIT #6
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753
Practice Address - Country:US
Practice Address - Phone:732-255-8000
Practice Address - Fax:732-255-4580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00394700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ174067Medicare PIN