Provider Demographics
NPI:1528547411
Name:PEAK WELLNESS FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:PEAK WELLNESS FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARRONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-770-5005
Mailing Address - Street 1:45 RIVER RD STE 1
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-1452
Mailing Address - Country:US
Mailing Address - Phone:908-795-3372
Mailing Address - Fax:
Practice Address - Street 1:45 RIVER RD STE 1
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-1452
Practice Address - Country:US
Practice Address - Phone:908-795-3370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-10
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00752700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty