Organization
PRIME SPINECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHANG PARK (MD/PRESIDENT)
(201) 482-0439
Entity
Organization
Contact information
Practice address
118 BROAD AVE STE N9, PALISADES PARK, NJ 07650-2721
(201) 482-0439
(201) 482-8703
Mailing address
118 BROAD AVE STE N9, PALISADES PARK, NJ 07650-2721
(201) 482-0439
(201) 482-8703
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00733100
NJ
Other
Enumeration date
02/05/2016
Last updated
03/07/2016
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