Organization
BALANCED WELL MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROTH RILEY MD (OWNER/PRESIDENT)
(201) 794-4500
Entity
Organization
Contact information
Practice address
26-01 PELLACK DR, FAIR LAWN, NJ 07410-3723
(201) 794-4500
(201) 794-4500
Mailing address
26-01 PELLACK DR, FAIR LAWN, NJ 07410-3723
(973) 742-6206
(973) 742-6206
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NJ
207R00000X
Internal Medicine Physician
Primary
—
NJ
Other
Enumeration date
06/30/2015
Last updated
07/21/2022
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