Individual
DR. JOHN R DE COTIIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
30 W HOLLY AVE, PITMAN, NJ 08071-1405
(856) 218-1330
(856) 218-1332
Mailing address
PO BOX 210, PITMAN, NJ 08071-0210
(856) 218-1330
(856) 218-1332
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00636000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001811403
IBX PPO
NJ
01
—
2646509000
AMERIHEALTH
NJ
01
—
7466688
AETNA
NJ
Enumeration date
06/14/2006
Last updated
05/18/2010
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