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Organization
JOHN LONGO
Active
Organization
JOHN LONGO
Active
Other names
Park Chiropractic Center, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN NICHOLAS LONGO DC (OWNER)
(973) 661-2303
Entity
Organization
Contact information
Practice address
715 BLOOMFIELD AVE, NUTLEY, NJ 07110-1021
(973) 661-2303
(973) 661-9141
Mailing address
715 BLOOMFIELD AVE, NUTLEY, NJ 07110-1021
(973) 661-2303
(973) 661-9141
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00205200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1474103
—
NJ
Enumeration date
12/01/2010
Last updated
12/01/2010
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