Provider Demographics
NPI:1194882845
Name:HEALING BRIDGE ALTERNATIVE THERAPY CENTER, LLC
Entity type:Organization
Organization Name:HEALING BRIDGE ALTERNATIVE THERAPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRAGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-628-0062
Mailing Address - Street 1:22 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-3115
Mailing Address - Country:US
Mailing Address - Phone:972-628-0062
Mailing Address - Fax:973-696-4423
Practice Address - Street 1:22 RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-3115
Practice Address - Country:US
Practice Address - Phone:972-628-0062
Practice Address - Fax:973-696-4423
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
NJ002266111NS0005X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty