Montclair Spine & Sports Rehab, LLC
Chiropractor in Montclair, NJ. Organization (NPI-2).
NPI number1164032140
StatusActive
Last updated in NPPESAug 5, 2020
Details
- NPI
- 1164032140
- Entity type
- Organization (NPI-2)
- Legal business name
- Montclair Spine & Sports Rehab, LLC
- Organization subpart
- No
- Enumeration date
- Aug 5, 2020
- Certification date
- Aug 5, 2020
- Last updated
- Aug 5, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | – | – | Yes |
Practice location
292 Bloomfield Ave Fl 2Montclair, NJ 07042-3624
Phone 973-942-0220 · Fax 973-942-0222
Mailing address
54 Lewis PlTotowa, NJ 07512-2648
Phone 973-885-8877 · Fax 973-942-0220
Authorized official
Jorge De La Torre
Owner
9739420220
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