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Organization
FAMILY CHIROPRACTIC OF CLARK LLC
Active
Organization
FAMILY CHIROPRACTIC OF CLARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRICIA MASTROPIETRO BA DC (OWNER)
(732) 388-3828
Entity
Organization
Contact information
Practice address
1114 RARITAN RD, SUITE 4, CLARK, NJ 07066-1330
(732) 388-3828
(732) 388-3829
Mailing address
1114 RARITAN RD, SUITE 4, CLARK, NJ 07066-1330
(732) 388-3828
(732) 388-3829
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00600800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3698573
AETNA ID #
NJ
01
—
P00192623
MEDICARE RAILROAD
NJ
01
—
P2901780
OXFORD ID
NJ
Enumeration date
05/24/2007
Last updated
04/09/2014
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