Provider Demographics
NPI:1902368145
Name:CHIROPRACTIC AND PT OF THE ORANGES, LLC
Entity Type:Organization
Organization Name:CHIROPRACTIC AND PT OF THE ORANGES, LLC
Other - Org Name:CHIROPRACTIC AND PT OF THE ORANGES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:862-930-5791
Mailing Address - Street 1:10 CHARLES ST # A
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2406
Mailing Address - Country:US
Mailing Address - Phone:770-873-5549
Mailing Address - Fax:973-821-5534
Practice Address - Street 1:2040 MILLBURN AVE STE 405
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3716
Practice Address - Country:US
Practice Address - Phone:862-930-5791
Practice Address - Fax:862-300-3570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-05
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty