Organization
THE SOURCE WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE BILQUIST D.C. (OWNER)
(732) 978-0951
Entity
Organization
Contact information
Practice address
1275 WESTFIELD AVE STE 1, RAHWAY, NJ 07065-1900
(732) 978-0951
Mailing address
1275 WESTFIELD AVE STE 1, RAHWAY, NJ 07065-1900
(732) 978-0951
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
12/28/2018
Last updated
12/28/2018
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