Provider Demographics
NPI:1790286672
Name:LABUSH CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:LABUSH CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:LABUSH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-888-0270
Mailing Address - Street 1:230 CENTENNIAL AVE
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-3137
Mailing Address - Country:US
Mailing Address - Phone:908-888-0270
Mailing Address - Fax:908-333-6262
Practice Address - Street 1:230 CENTENNIAL AVE
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-3137
Practice Address - Country:US
Practice Address - Phone:908-888-0270
Practice Address - Fax:908-333-6262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-26
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00566900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty