Provider Demographics
NPI:1528606597
Name:ALTUM CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ALTUM CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:856-454-7372
Mailing Address - Street 1:484 EVESHAM RD STE 5
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3318
Mailing Address - Country:US
Mailing Address - Phone:856-454-7372
Mailing Address - Fax:856-559-7847
Practice Address - Street 1:484 EVESHAM RD STE 5
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-3318
Practice Address - Country:US
Practice Address - Phone:856-454-7372
Practice Address - Fax:856-559-7847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty