Provider Demographics
NPI:1841407111
Name:HIGHTSTOWN CHIROPRACTIC LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:HIGHTSTOWN CHIROPRACTIC LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:WEINMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-443-6161
Mailing Address - Street 1:226 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:HIGHTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-3224
Mailing Address - Country:US
Mailing Address - Phone:609-443-6161
Mailing Address - Fax:609-443-8904
Practice Address - Street 1:226 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:HIGHTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08520-3224
Practice Address - Country:US
Practice Address - Phone:609-443-6161
Practice Address - Fax:609-443-8904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00593800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMA44592Medicare UPIN