Organization
LIGHTSOURCE CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JODI NICHOLE DINNERMAN DC (OWNER)
(908) 399-3499
Entity
Organization
Contact information
Practice address
6 EAST MAIN STREET, SUITE 6, CLINTON, NJ 08809
(908) 399-3499
Mailing address
6 EAST MAIN STREET, SUITE 6, CLINTON, NJ 08809
(908) 399-3499
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
MC05797
NJ
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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