Provider Demographics
NPI:1306029442
Name:CARLEEN A. THUM D.C. P.C.
Entity Type:Organization
Organization Name:CARLEEN A. THUM D.C. P.C.
Other - Org Name:RIVER'S EDGE CHIROPRACTIC, P.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLEEN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:THUM
Authorized Official - Suffix:
Authorized Official - Credentials:DC PC
Authorized Official - Phone:609-250-3188
Mailing Address - Street 1:88 ORCHARD RD., SUITE 4
Mailing Address - Street 2:CARLEEN A. THUM D.C. P.C.
Mailing Address - City:SKILLMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08558-2642
Mailing Address - Country:US
Mailing Address - Phone:609-250-3188
Mailing Address - Fax:
Practice Address - Street 1:88 ORCHARD RD. SUITE 4
Practice Address - Street 2:CARLEEN A. THUM D.C. P.C. GENTLE CHIROPRACTIC
Practice Address - City:SKILLMAN
Practice Address - State:NJ
Practice Address - Zip Code:08558-2642
Practice Address - Country:US
Practice Address - Phone:609-250-3188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00561700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
087197Medicare PIN