Provider Demographics
NPI:1972268985
Name:VITAL BRAIN & SPINE
Entity type:Organization
Organization Name:VITAL BRAIN & SPINE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RADWANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-202-5210
Mailing Address - Street 1:953 US HIGHWAY 202 N
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-3791
Mailing Address - Country:US
Mailing Address - Phone:908-955-8180
Mailing Address - Fax:
Practice Address - Street 1:953 US HIGHWAY 202 N
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-3791
Practice Address - Country:US
Practice Address - Phone:908-955-8180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty