Provider Demographics
NPI:1285040964
Name:ABSOLUTE CHIROPRACTIC & MASSAGE, LLC
Entity Type:Organization
Organization Name:ABSOLUTE CHIROPRACTIC & MASSAGE, LLC
Other - Org Name:ABSOLUTE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZZEO
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:732-874-5109
Mailing Address - Street 1:245 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-1958
Mailing Address - Country:US
Mailing Address - Phone:732-874-5109
Mailing Address - Fax:732-874-5134
Practice Address - Street 1:245 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-1958
Practice Address - Country:US
Practice Address - Phone:732-874-5109
Practice Address - Fax:732-874-5134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00608100111N00000X
171100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty