Organization
ICC MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO BARRESE (OWNER)
(973) 343-5190
Entity
Organization
Contact information
Practice address
721 CLIFTON AVE STE 101, CLIFTON, NJ 07013-1880
(973) 343-5190
Mailing address
721 CLIFTON AVE STE 101, CLIFTON, NJ 07013-1880
(973) 343-5190
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
01/21/2025
Last updated
01/21/2025
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