Provider Demographics
NPI:1710024559
Name:HUNTER, MARY VICTORIA (DC)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:VICTORIA
Last Name:HUNTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-9469
Mailing Address - Country:US
Mailing Address - Phone:856-478-9747
Mailing Address - Fax:856-478-4007
Practice Address - Street 1:1 ORCHARD DR
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-9469
Practice Address - Country:US
Practice Address - Phone:856-478-9747
Practice Address - Fax:856-478-4007
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00207800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0075628000OtherAMERIHEALTH HMO
NJHUO63554Medicare ID - Type UnspecifiedMEDICARE
NJU50757Medicare UPIN