Organization
ATLANTIC BACK AND BODY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALYNN T. DRAKE DC (OWNER/DOCTOR)
(310) 989-8850
Entity
Organization
Contact information
Practice address
8 QUAKERBRIDGE PLZ STE 1, HAMILTON, NJ 08619-1255
(310) 989-8850
Mailing address
8 QUAKERBRIDGE PLZ STE 1, HAMILTON, NJ 08619-1255
(310) 989-8850
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00738900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38MC00738900
LICENSE NUMBER
NJ
Enumeration date
10/03/2016
Last updated
10/24/2016
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