Provider Demographics
NPI:1194933184
Name:PETITO-ROSS CHIROPRACTIC CENTER, P.C.
Entity type:Organization
Organization Name:PETITO-ROSS CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-581-1300
Mailing Address - Street 1:1301 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3826
Mailing Address - Country:US
Mailing Address - Phone:609-581-1300
Mailing Address - Fax:609-581-9026
Practice Address - Street 1:1301 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-3826
Practice Address - Country:US
Practice Address - Phone:609-581-1300
Practice Address - Fax:609-581-9026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty