Provider Demographics
NPI:1306063888
Name:STRUEBY, JACQUELINE SUZANNE (DC)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:SUZANNE
Last Name:STRUEBY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 W COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2015
Mailing Address - Country:US
Mailing Address - Phone:732-415-1401
Mailing Address - Fax:732-415-1403
Practice Address - Street 1:2080 W COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2015
Practice Address - Country:US
Practice Address - Phone:732-415-1401
Practice Address - Fax:732-415-1403
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00654500111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation