Organization
21ST CENTURY TOTAL HEALTH CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KESNOLD BAPTISTE DC (PRESIDENT)
(908) 625-7463
Entity
Organization
Contact information
Practice address
439 MAIN ST, SUITE 101, ORANGE, NJ 07050-1523
(973) 675-8700
(973) 675-8701
Mailing address
439 MAIN ST, SUITE 101, ORANGE, NJ 07050-1523
(973) 675-8700
(973) 675-8701
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
38MCOO641500
NJ
Other
Enumeration date
09/17/2013
Last updated
08/04/2016
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