Provider Demographics
NPI:1679738454
Name:BURLINGTON COUNTY CHIROPRACTIC
Entity Type:Organization
Organization Name:BURLINGTON COUNTY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:NICOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-387-9242
Mailing Address - Street 1:1105 SUNSET RD
Mailing Address - Street 2:SUITE E & F
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-2290
Mailing Address - Country:US
Mailing Address - Phone:609-387-1910
Mailing Address - Fax:609-387-5122
Practice Address - Street 1:1105 SUNSET RD
Practice Address - Street 2:SUITE E & F
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-2290
Practice Address - Country:US
Practice Address - Phone:609-387-1910
Practice Address - Fax:609-387-5122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00591600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty