Provider Demographics
NPI:1295457109
Name:FORKED RIVER CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:FORKED RIVER CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PALUK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-489-1042
Mailing Address - Street 1:1578 CLAIR RD
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-3400
Mailing Address - Country:US
Mailing Address - Phone:609-489-1042
Mailing Address - Fax:
Practice Address - Street 1:900 NEWARK AVE
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-1012
Practice Address - Country:US
Practice Address - Phone:609-604-6005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty