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Individual

DOMINIC MAZZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C

Contact information

Practice address
36 LYDIA DR, GUTTENBERG, NJ 07093-8366
(201) 317-6104
(201) 868-0874
Mailing address
36 LYDIA DR, GUTTENBERG, NJ 07093-8366
(201) 317-6104
(201) 868-0874

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00553500
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
38MC00553500
NJ LICENSE NUMBER
NJ
Enumeration date
12/08/2008
Last updated
07/14/2014
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