Provider Demographics
NPI:1306016241
Name:NETWORK CHIROPRACTIC OF SOMERSET, P.C.
Entity Type:Organization
Organization Name:NETWORK CHIROPRACTIC OF SOMERSET, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-398-1600
Mailing Address - Street 1:1555 RUTH ROAD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902
Mailing Address - Country:US
Mailing Address - Phone:732-398-1600
Mailing Address - Fax:732-398-1616
Practice Address - Street 1:1555 RUTH ROAD
Practice Address - Street 2:SUITE 3
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902
Practice Address - Country:US
Practice Address - Phone:732-398-1600
Practice Address - Fax:732-398-1616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ852944Medicare PIN