Provider Demographics
NPI:1467165282
Name:PARK RIDGE CHIROPRACTIC
Entity Type:Organization
Organization Name:PARK RIDGE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHANEC
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-248-2086
Mailing Address - Street 1:75 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07656-1241
Mailing Address - Country:US
Mailing Address - Phone:201-248-2086
Mailing Address - Fax:
Practice Address - Street 1:75 PARK AVE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07656-1241
Practice Address - Country:US
Practice Address - Phone:201-248-2086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty