Provider Demographics
NPI:1881052041
Name:BURLINGTON SPINE & REHAB, LLC
Entity type:Organization
Organization Name:BURLINGTON SPINE & REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-526-5652
Mailing Address - Street 1:41 S ROUTE 73
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-9448
Mailing Address - Country:US
Mailing Address - Phone:609-704-1857
Mailing Address - Fax:609-704-1859
Practice Address - Street 1:81 SOMERSET DR STE E-F
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-1434
Practice Address - Country:US
Practice Address - Phone:609-526-5652
Practice Address - Fax:609-526-4022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00349500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty