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Organization
ACTIVELIFE REGENERATIVE THERAPIES
Active
Organization
ACTIVELIFE REGENERATIVE THERAPIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH WOLOSZ DC (OWNER)
(973) 997-0542
Entity
Organization
Contact information
Practice address
413 WANAQUE AVE, POMPTON LAKES, NJ 07442-1844
(973) 997-0542
(973) 831-6763
Mailing address
413 WANAQUE AVE, POMPTON LAKES, NJ 07442-1844
(973) 997-0542
(973) 831-6763
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/15/2021
Last updated
01/05/2022
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