Individual
DR. GRAISON TJELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7 MERIDIAN RD, EATONTOWN, NJ 07724-2242
(732) 935-1000
(732) 935-9100
Mailing address
7 MERIDIAN RD, EATONTOWN, NJ 07724-2242
(815) 762-2534
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00767200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38MC00767200
STATE LICENSE
NJ
Enumeration date
01/08/2020
Last updated
01/08/2020
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