# BLOOMFIELD TOTAL HEALTH CENTER

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

## Provider details

- **NPI number:** 1639105380
- **Authorized official:** DR. MICHAEL M CREDICO DC (OWNER)
- **Authorized official phone:** (973) 338-3620

## Contact information

- **Practice address:** 1129 BROAD ST, BLOOMFIELD, NJ 07003-2918
- **Practice address phone:** (973) 338-3620
- **Practice address fax:** (973) 338-4849
- **Mailing address:** 1129 BROAD ST, BLOOMFIELD, NJ 07003-2918
- **Mailing address phone:** (973) 338-3620
- **Mailing address fax:** (973) 338-4849

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NS0005X | Sports Physician Chiropractor | — | NULL | — |
| 111NS0005X | Sports Physician Chiropractor | — | — | — |
| 171100000X | Acupuncturist | — | NULL | Yes |
| 171100000X | Acupuncturist | — | — | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 06/24/2006
- **Last updated:** 01/29/2018