Provider Demographics
NPI:1598821977
Name:MCBRIDE, JOSEPH W JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:W
Last Name:MCBRIDE
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 PEMBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-2729
Mailing Address - Country:US
Mailing Address - Phone:856-778-4338
Mailing Address - Fax:
Practice Address - Street 1:228 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-2480
Practice Address - Country:US
Practice Address - Phone:856-914-1000
Practice Address - Fax:856-914-1001
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00448500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ747478Medicare ID - Type Unspecified