Provider Demographics
NPI:1134858004
Name:CHIROPRACTIC AND REHAB EXERCISE CENTER CARECENTER OF S JERSEY NORTH
Entity type:Organization
Organization Name:CHIROPRACTIC AND REHAB EXERCISE CENTER CARECENTER OF S JERSEY NORTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIAL
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-616-0610
Mailing Address - Street 1:1937 HADDONFIELD BERLIN RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3737
Mailing Address - Country:US
Mailing Address - Phone:856-616-0610
Mailing Address - Fax:
Practice Address - Street 1:623 TILTON RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1219
Practice Address - Country:US
Practice Address - Phone:609-645-8954
Practice Address - Fax:609-645-2935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty