Provider Demographics
NPI:1477715126
Name:KILMER CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:KILMER CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CUZZO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-972-0388
Mailing Address - Street 1:191 ROUTE 9 SOUTH
Mailing Address - Street 2:MARLBORO TOWNSHIP
Mailing Address - City:ENGLISHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8276
Mailing Address - Country:US
Mailing Address - Phone:732-972-0388
Mailing Address - Fax:732-972-6911
Practice Address - Street 1:191 ROUTE 9 SOUTH
Practice Address - Street 2:MARLBORO TOWNSHIP
Practice Address - City:ENGLISHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8276
Practice Address - Country:US
Practice Address - Phone:732-972-0388
Practice Address - Fax:732-972-6911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC2202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ513598Medicare PIN