Provider Demographics
NPI:1225675903
Name:MONMOUTH PAIN AT HOWELL LLC
Entity Type:Organization
Organization Name:MONMOUTH PAIN AT HOWELL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DANDREA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-863-7400
Mailing Address - Street 1:1001 US HIGHWAY 9 STE 101
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3301
Mailing Address - Country:US
Mailing Address - Phone:732-863-7400
Mailing Address - Fax:732-863-7497
Practice Address - Street 1:1001 US HIGHWAY 9 STE 101
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3301
Practice Address - Country:US
Practice Address - Phone:732-863-7400
Practice Address - Fax:732-863-7497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty