Organization
NETTIS FAMILY CHIROPRACTIC, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS NETTIS (DC, OWNER)
(732) 229-2000
Entity
Organization
Contact information
Practice address
1056 BROADWAY, WEST LONG BRANCH, NJ 07764-1308
(732) 229-2000
Mailing address
1056 BROADWAY, WEST LONG BRANCH, NJ 07764-1308
(732) 229-2000
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
MC04515
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080106
MEDICARE GROUP #
NJ
Enumeration date
08/29/2007
Last updated
08/29/2007
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