Provider Demographics
NPI:1245463728
Name:LOPATCONG CHIROPRACTIC LLC
Entity type:Organization
Organization Name:LOPATCONG CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-703-1356
Mailing Address - Street 1:108 BEATTYS RD
Mailing Address - Street 2:
Mailing Address - City:STEWARTSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08886-2201
Mailing Address - Country:US
Mailing Address - Phone:973-703-1356
Mailing Address - Fax:
Practice Address - Street 1:404 ROUTE 57
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-9407
Practice Address - Country:US
Practice Address - Phone:973-703-1356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00197800261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service