Provider Demographics
NPI:1801916937
Name:AUDUBON BACK AID CENTER
Entity type:Organization
Organization Name:AUDUBON BACK AID CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-547-7722
Mailing Address - Street 1:246 S WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-1352
Mailing Address - Country:US
Mailing Address - Phone:856-456-2996
Mailing Address - Fax:856-547-6607
Practice Address - Street 1:246 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1352
Practice Address - Country:US
Practice Address - Phone:856-456-2996
Practice Address - Fax:856-547-6607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00187600111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty