Provider Demographics
NPI:1508063009
Name:FAMILY CHIROPRACTIC & SPINAL HEALTH CARE CENTER LLC
Entity Type:Organization
Organization Name:FAMILY CHIROPRACTIC & SPINAL HEALTH CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:R
Authorized Official - Last Name:ABTAHI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-995-9900
Mailing Address - Street 1:27 S FRANKLIN TPKE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2550
Mailing Address - Country:US
Mailing Address - Phone:201-995-9900
Mailing Address - Fax:201-995-9901
Practice Address - Street 1:27 S FRANKLIN TPKE
Practice Address - Street 2:SUITE 302
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-2550
Practice Address - Country:US
Practice Address - Phone:201-995-9900
Practice Address - Fax:201-995-9901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00659700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty