Individual
BRIAN R SHADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
43 MAIN ST, FARMINGDALE, NJ 07727-1326
(732) 751-9500
Mailing address
43 MAIN ST, FARMINGDALE, NJ 07727-1326
(732) 751-9500
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00554600
NJ
Other
Enumeration date
06/06/2006
Last updated
07/08/2007
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