Dr Jonathan Dale, DC | |
666 Godwin Ave Ste 110, Midland Park, NJ 07432-1463 | |
(201) 444-3004 | |
Not Available |
Full Name | Dr Jonathan Dale |
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Gender | Male |
Speciality | Chiropractor |
Location | 666 Godwin Ave Ste 110, Midland Park, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679987614 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 38MC00714100 (New Jersey) | Primary |
Provider Name | Dale Family Chiropractic Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1932866670 PECOS PAC ID: 6901297910 Enrollment ID: O20211230001790 |
Mailing Address | Practice Location Address |
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Dr Jonathan Dale, DC 666 Godwin Ave Ste 110, Midland Park, NJ 07432-1463 Ph: (201) 444-3004 | Dr Jonathan Dale, DC 666 Godwin Ave Ste 110, Midland Park, NJ 07432-1463 Ph: (201) 444-3004 |
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