Provider Demographics
NPI:1508369158
Name:ATLANTIC SHORE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ATLANTIC SHORE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:TOBEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-774-6810
Mailing Address - Street 1:1325 WARREN AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07762-2567
Mailing Address - Country:US
Mailing Address - Phone:845-774-6810
Mailing Address - Fax:
Practice Address - Street 1:1325 WARREN AVE STE 8
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07762-2567
Practice Address - Country:US
Practice Address - Phone:845-774-6810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-09
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00436600261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service