Provider Demographics
NPI:1790594810
Name:ADVANCED CHIROPRACTIC AND REHAD OF ATCO LLC
Entity type:Organization
Organization Name:ADVANCED CHIROPRACTIC AND REHAD OF ATCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMENTS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-560-4088
Mailing Address - Street 1:429 WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:ATCO
Mailing Address - State:NJ
Mailing Address - Zip Code:08004-2227
Mailing Address - Country:US
Mailing Address - Phone:609-560-4088
Mailing Address - Fax:
Practice Address - Street 1:429 WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:ATCO
Practice Address - State:NJ
Practice Address - Zip Code:08004-2227
Practice Address - Country:US
Practice Address - Phone:609-560-4088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-03
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty