Provider Demographics
NPI:1881834976
Name:BILAS, JOHN R (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:BILAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:
Other - Last Name:BILAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:514 BRINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BRADLEY BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:07720-1312
Mailing Address - Country:US
Mailing Address - Phone:609-204-2092
Mailing Address - Fax:
Practice Address - Street 1:514 BRINLEY AVE
Practice Address - Street 2:
Practice Address - City:BRADLEY BEACH
Practice Address - State:NJ
Practice Address - Zip Code:07720-1312
Practice Address - Country:US
Practice Address - Phone:609-204-2092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2715111NN1001X
NJ36MC00208000111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition