Provider Demographics
NPI:1518103597
Name:CHIROPRACTIC FAMILY CENTER OF BRICKTOWN
Entity Type:Organization
Organization Name:CHIROPRACTIC FAMILY CENTER OF BRICKTOWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-920-8188
Mailing Address - Street 1:PO BOX 4266
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-1466
Mailing Address - Country:US
Mailing Address - Phone:732-920-8188
Mailing Address - Fax:732-920-1740
Practice Address - Street 1:228 DRUM POINT RD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6312
Practice Address - Country:US
Practice Address - Phone:732-920-8188
Practice Address - Fax:732-920-8188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-23
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1356326912OtherINDIVIDUAL NPI NUMBER TYPE CODE 1
NJ041127Medicare PIN
NJ1356326912OtherINDIVIDUAL NPI NUMBER TYPE CODE 1