# BACK AND NECK CENTER OF BRICK LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134374564
- **Authorized official:** DR. THEODORE M KOZIOL DC (CHIROPRACTOR)
- **Authorized official phone:** (732) 477-6767

## Contact information

- **Practice address:** 387 BRICK BLVD, BRICK, NJ 08723-6010
- **Practice address phone:** (732) 477-6767
- **Practice address fax:** (732) 477-9333
- **Mailing address:** 387 BRICK BLVD, BRICK, NJ 08723-6010
- **Mailing address phone:** (732) 477-6767
- **Mailing address fax:** (732) 477-9333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 38MC00329800 | NJ | Yes |

## Other

- **Enumeration date:** 11/26/2008
- **Last updated:** 06/24/2014