Provider Demographics
NPI:1871654723
Name:TOTAL WELLNESS OF NJ, INC.
Entity Type:Organization
Organization Name:TOTAL WELLNESS OF NJ, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PETITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-663-5633
Mailing Address - Street 1:28 BOWLING GREEN PKWY STE 1A
Mailing Address - Street 2:
Mailing Address - City:LAKE HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07849-2445
Mailing Address - Country:US
Mailing Address - Phone:973-663-5633
Mailing Address - Fax:973-663-5762
Practice Address - Street 1:28 BOWLING GREEN PKWY STE 1A
Practice Address - Street 2:
Practice Address - City:LAKE HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07849
Practice Address - Country:US
Practice Address - Phone:973-663-5633
Practice Address - Fax:973-663-5762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC05066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty