Provider Demographics
NPI:1376820357
Name:DEAN CHIROPRACTIC & PAIN RELIEF, INC.
Entity Type:Organization
Organization Name:DEAN CHIROPRACTIC & PAIN RELIEF, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAUTE
Authorized Official - Middle Name:KENYA
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:856-222-1322
Mailing Address - Street 1:1930 MARLTON PIKE E STE J51
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-4106
Mailing Address - Country:US
Mailing Address - Phone:856-222-1322
Mailing Address - Fax:856-222-9632
Practice Address - Street 1:1930 MARLTON PIKE E STE J51
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-4106
Practice Address - Country:US
Practice Address - Phone:856-222-1322
Practice Address - Fax:856-222-9632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-04
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00681800111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0707473Medicaid