# JERSEY INTEGRATIVE SPINE & SPORTS, PC

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

## Provider details

- **NPI number:** 1578103388
- **Authorized official:** JOSE CAMPOS MD (PRESIDENT)
- **Authorized official phone:** (862) 666-9285

## Contact information

- **Practice address:** 408 MAIN ST STE 401, BOONTON, NJ 07005-1732
- **Practice address phone:** (973) 794-6611
- **Mailing address:** 901 RT 23, 2ND FLOOR, POMPTON PLAINS, NJ 07444
- **Mailing address phone:** (862) 666-9285

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |

## Other

- **Enumeration date:** 01/09/2020
- **Last updated:** 01/09/2020