# SPINE AND SPORTS MEDICINE OF MANCHESTER

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

## Provider details

- **NPI number:** 1871043182
- **Authorized official:** MATTHEW LEGOWSKI (OPERATIONS)
- **Authorized official phone:** (609) 703-5097

## Contact information

- **Practice address:** 60 LACEY RD, WHITING, NJ 08759-2921
- **Practice address phone:** (732) 408-4492
- **Mailing address:** 60 LACEY RD, WHITING, NJ 08759-2921

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | 25MB09673700 | NJ | Yes |

## Other

- **Enumeration date:** 10/11/2016
- **Last updated:** 10/11/2016