Life Clinic Of Nj Dc Pa | |
7 Forrestal Road S, Plainsborough, NJ 08536 | |
(612) 868-6894 | |
Not Available |
Full Name | Life Clinic Of Nj Dc Pa |
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Type | Facility |
Speciality | Chiropractor |
Location | 7 Forrestal Road S, Plainsborough, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1720575178 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 38MC00735800 (New Jersey) | Primary |
Provider Name | Logan W Luzadder |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1356894117 PECOS PAC ID: 9133494008 Enrollment ID: I20171003003937 |
Provider Name | Ian Raphael Barry |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1417412966 PECOS PAC ID: 1759621543 Enrollment ID: I20190313002517 |
Provider Name | Roger Mitchell |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1326562034 PECOS PAC ID: 6103198692 Enrollment ID: I20190722003436 |
Provider Name | Jonathan M Segreti |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1114485398 PECOS PAC ID: 2365872801 Enrollment ID: I20200423001330 |
Provider Name | Vincent J Martino |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1962538223 PECOS PAC ID: 1456798073 Enrollment ID: I20240319001302 |
Mailing Address | Practice Location Address |
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Life Clinic Of Nj Dc Pa Po Box 549, Chanhassen, MN 55317-0549 Ph: (612) 868-6894 | Life Clinic Of Nj Dc Pa 7 Forrestal Road S, Plainsborough, NJ 08536 Ph: (612) 868-6894 |