Provider Demographics
NPI:1417440363
Name:POWER ON CHIROPRACTIC CENTER,LLC
Entity Type:Organization
Organization Name:POWER ON CHIROPRACTIC CENTER,LLC
Other - Org Name:SOUTH HOLMDEL CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PORCARO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-946-2999
Mailing Address - Street 1:12 S HOLMDEL RD
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-2130
Mailing Address - Country:US
Mailing Address - Phone:732-946-2999
Mailing Address - Fax:732-946-2999
Practice Address - Street 1:12 S HOLMDEL RD
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-2130
Practice Address - Country:US
Practice Address - Phone:732-946-2999
Practice Address - Fax:732-946-2999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00574900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty