Provider Demographics
NPI:1598084840
Name:PAIN RELIEF WELLNESS CENTER, P.C.
Entity Type:Organization
Organization Name:PAIN RELIEF WELLNESS CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHESNEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:201-755-0081
Mailing Address - Street 1:193 RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:NORTH ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07031
Mailing Address - Country:US
Mailing Address - Phone:201-755-0081
Mailing Address - Fax:201-991-0642
Practice Address - Street 1:711-715 32ND STREET
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087
Practice Address - Country:US
Practice Address - Phone:201-755-0081
Practice Address - Fax:201-991-0642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC002412111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty