Provider Demographics
NPI:1194882167
Name:COMPLETE CHIROPRACTIC PC
Entity type:Organization
Organization Name:COMPLETE CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:DEMETRIOU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-839-3010
Mailing Address - Street 1:498 RINGWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WANAQUE
Mailing Address - State:NJ
Mailing Address - Zip Code:07465-2315
Mailing Address - Country:US
Mailing Address - Phone:973-839-3010
Mailing Address - Fax:973-839-3015
Practice Address - Street 1:498 RINGWOOD AVE
Practice Address - Street 2:
Practice Address - City:WANAQUE
Practice Address - State:NJ
Practice Address - Zip Code:07465-2315
Practice Address - Country:US
Practice Address - Phone:973-839-3010
Practice Address - Fax:973-839-3015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00444500111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1679525364OtherNPI #
NJ38MC00444500OtherSTATE LICENSE #
NJ38MC00444500OtherSTATE LICENSE #