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Organization
STATE LINE CHIROPRACTIC AND WELLNESS CENTER INC
Active
Organization
STATE LINE CHIROPRACTIC AND WELLNESS CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES WILLIAM MATTISON JR. DC (PRESIDENT)
(908) 454-8808
Entity
Organization
Contact information
Practice address
480 MEMORIAL PKWY, PHILLIPSBURG, NJ 08865-1575
(908) 454-8808
(908) 998-4762
Mailing address
480 MEMORIAL PKWY, PHILLIPSBURG, NJ 08865-1575
(908) 454-8808
(908) 998-4762
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00514100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
087692
MEDICARE
NJ
Enumeration date
04/24/2007
Last updated
07/15/2013
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