Provider Demographics
NPI:1619011236
Name:RT.36 CHIROPRACTIC REHABILITATION
Entity Type:Organization
Organization Name:RT.36 CHIROPRACTIC REHABILITATION
Other - Org Name:OPTIMUM REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:BEKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-251-3156
Mailing Address - Street 1:351 E GREYSTONE RD
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-4024
Mailing Address - Country:US
Mailing Address - Phone:732-251-3156
Mailing Address - Fax:
Practice Address - Street 1:265 STATE ROUTE 36
Practice Address - Street 2:#106
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1036
Practice Address - Country:US
Practice Address - Phone:732-380-0291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty