Organization
JOHN LONGO
Active
Other names
Park Chiropractic Center, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN NICHOLAS LONGO DC (OWNER)
(973) 661-2303
Entity
Organization
Contact information
Practice address
715 BLOOMFIELD AVE, NUTLEY, NJ 07110-1021
(973) 661-2303
(973) 661-9141
Mailing address
715 BLOOMFIELD AVE, NUTLEY, NJ 07110-1021
(973) 661-2303
(973) 661-9141
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00205200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1474103
—
NJ
Enumeration date
12/01/2010
Last updated
12/01/2010
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