Provider Demographics
NPI:1528293719
Name:PRECISION CHIROPRACTIC CENTER LLC
Entity type:Organization
Organization Name:PRECISION CHIROPRACTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KROOPNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-883-0495
Mailing Address - Street 1:133 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4416
Mailing Address - Country:US
Mailing Address - Phone:201-883-0495
Mailing Address - Fax:201-343-0777
Practice Address - Street 1:133 CEDAR LN
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4416
Practice Address - Country:US
Practice Address - Phone:201-883-0495
Practice Address - Fax:201-343-0777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009717-1261QM2500X
NJ38MC005657261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ044138Medicare UPIN