Provider Demographics
NPI:1306120241
Name:SPADAFINO CHIROPRACTIC AND WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:SPADAFINO CHIROPRACTIC AND WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPADAFINO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-254-0800
Mailing Address - Street 1:281 SUMMERHILL RD
Mailing Address - Street 2:SUITE102
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4279
Mailing Address - Country:US
Mailing Address - Phone:732-254-0800
Mailing Address - Fax:732-390-5420
Practice Address - Street 1:281 SUMMERHILL RD
Practice Address - Street 2:SUITE102
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4279
Practice Address - Country:US
Practice Address - Phone:732-254-0800
Practice Address - Fax:732-390-5420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-10
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC03472111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty