Provider Demographics
NPI:1982822524
Name:CHIROPRACTORS ON THE MOVE, LLP
Entity Type:Organization
Organization Name:CHIROPRACTORS ON THE MOVE, LLP
Other - Org Name:DEITCH FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:DEITCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-897-1200
Mailing Address - Street 1:50 HIGHTSTOWN RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-1107
Mailing Address - Country:US
Mailing Address - Phone:609-897-1200
Mailing Address - Fax:609-897-0900
Practice Address - Street 1:50 HIGHTSTOWN RD
Practice Address - Street 2:SUITE D
Practice Address - City:PRINCETON JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08550-1107
Practice Address - Country:US
Practice Address - Phone:609-897-1200
Practice Address - Fax:609-897-0900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC 05659111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5043OtherGA LICENSE
NYX009747OtherNY LICENSE
FLCH6617OtherFL LICENSE
NJMC 05659OtherNJ LICENSE
NJ0027634Medicaid
NJ0027634Medicaid
NJ045014Medicare ID - Type UnspecifiedMEDICARE