Provider Demographics
NPI:1942723069
Name:CHIROPRACTIC AND REHABILITATION CENTER OF MORRIS, LLC
Entity Type:Organization
Organization Name:CHIROPRACTIC AND REHABILITATION CENTER OF MORRIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-359-4400
Mailing Address - Street 1:7 RIDGEDALE AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:CEDAR KNOLLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07927-1120
Mailing Address - Country:US
Mailing Address - Phone:973-359-4400
Mailing Address - Fax:973-359-4414
Practice Address - Street 1:7 RIDGEDALE AVE STE 203
Practice Address - Street 2:
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927-1120
Practice Address - Country:US
Practice Address - Phone:973-359-4400
Practice Address - Fax:973-359-4414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00176600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty