Organization
JOSEPH J LICITRA DC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH LICITRA (MANAGING MEMBER)
(973) 470-0632
Entity
Organization
Contact information
Practice address
925 ALLWOOD RD, CLIFTON, NJ 07012-1941
(973) 470-0632
(973) 473-8852
Mailing address
925 ALLWOOD RD, CLIFTON, NJ 07012-1941
(973) 470-0632
(973) 473-8852
Taxonomy
Speciality
Code
Description
License number
State
111NI0013X
Independent Medical Examiner Chiropractor
Primary
—
—
Other
Enumeration date
01/19/2021
Last updated
01/19/2021
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