Provider Demographics
NPI:1265504039
Name:WESTWOOD FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:WESTWOOD FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR (OWNER)
Authorized Official - Prefix:DR
Authorized Official - First Name:JETT
Authorized Official - Middle Name:
Authorized Official - Last Name:GURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-664-4488
Mailing Address - Street 1:99 KINDERKAMACK RD STE 112
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3020
Mailing Address - Country:US
Mailing Address - Phone:201-664-4488
Mailing Address - Fax:201-664-4501
Practice Address - Street 1:99 KINDERKAMACK RD STE 112
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3020
Practice Address - Country:US
Practice Address - Phone:201-664-4488
Practice Address - Fax:201-664-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC 00 277300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ536594Medicare ID - Type Unspecified