Provider Demographics
NPI:1285659094
Name:VALLEY CHIROPRACTIC AND WELLNESS CENTER
Entity Type:Organization
Organization Name:VALLEY CHIROPRACTIC AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MANAGING EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:HYJEK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-876-8777
Mailing Address - Street 1:2 MOUNTAIN VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LONG VALLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07853-3122
Mailing Address - Country:US
Mailing Address - Phone:908-876-8777
Mailing Address - Fax:908-876-8788
Practice Address - Street 1:2 MOUNTAIN VIEW AVE
Practice Address - Street 2:
Practice Address - City:LONG VALLEY
Practice Address - State:NJ
Practice Address - Zip Code:07853-3122
Practice Address - Country:US
Practice Address - Phone:908-876-8777
Practice Address - Fax:908-876-8788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00642700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty