Organization
186 FAIRFIELD ROAD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEN M RUSSO DC (CHIROPRACTIC)
(973) 227-3388
Entity
Organization
Contact information
Practice address
186 FAIRFIELD RD, FAIRFIELD, NJ 07004-2423
(973) 227-3388
(973) 227-0887
Mailing address
39 JOHN ST, FAIRFIELD, NJ 07004-1438
(973) 227-3388
(973) 227-0887
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4005
NJ
Other
Enumeration date
06/11/2007
Last updated
07/17/2009
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