Provider Demographics
NPI:1407589682
Name:INNATE RESTORATIVE HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:INNATE RESTORATIVE HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:J
Authorized Official - Last Name:RIVERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-887-3881
Mailing Address - Street 1:1 CHINGARORA AVE
Mailing Address - Street 2:
Mailing Address - City:KEYPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07735-1007
Mailing Address - Country:US
Mailing Address - Phone:732-887-3881
Mailing Address - Fax:
Practice Address - Street 1:421 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3627
Practice Address - Country:US
Practice Address - Phone:609-486-2150
Practice Address - Fax:609-486-2149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty