Provider Demographics
NPI:1982928057
Name:FRIENDS AND FAMILY CHIROPRACTIC L.L.C.
Entity Type:Organization
Organization Name:FRIENDS AND FAMILY CHIROPRACTIC L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRTACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:COUNT
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-583-1355
Mailing Address - Street 1:4309 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-2658
Mailing Address - Country:US
Mailing Address - Phone:201-583-1355
Mailing Address - Fax:201-583-1350
Practice Address - Street 1:4309 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-2658
Practice Address - Country:US
Practice Address - Phone:201-583-1355
Practice Address - Fax:201-583-1350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00620700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty