Provider Demographics
NPI:1013491232
Name:PRECISION SPORTS AND SPINE WOODBRIDGE, INC
Entity Type:Organization
Organization Name:PRECISION SPORTS AND SPINE WOODBRIDGE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-772-3703
Mailing Address - Street 1:675 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-3152
Mailing Address - Country:US
Mailing Address - Phone:732-326-2348
Mailing Address - Fax:732-582-6936
Practice Address - Street 1:675 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-3152
Practice Address - Country:US
Practice Address - Phone:732-326-2348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1699288696OtherCHIROPRACTOR
NJ1518417971OtherPHYSICAL THERAPIST
NJ1861837742OtherPHYSCIAL THERAPY
NJ1659886422OtherACUPUNCTURIST