Provider Demographics
NPI:1407224389
Name:CHIROPRACTIC HEALTH CLINIC OF SPARTA, LLC
Entity Type:Organization
Organization Name:CHIROPRACTIC HEALTH CLINIC OF SPARTA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-214-5161
Mailing Address - Street 1:33 WOODPORT RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-2431
Mailing Address - Country:US
Mailing Address - Phone:973-214-5161
Mailing Address - Fax:
Practice Address - Street 1:33 WOODPORT RD
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-2431
Practice Address - Country:US
Practice Address - Phone:973-214-5161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC04489111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty