Individual
CASEY PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
144 ROUTE 34, MATAWAN, NJ 07747-2132
(732) 320-6285
Mailing address
150A TICES LN, EAST BRUNSWICK, NJ 08816-2015
(732) 307-8406
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00789200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38MC00789200
LICENSE NUMBER
NJ
Enumeration date
01/24/2022
Last updated
01/26/2022
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