Organization
ADVANCED HEALING & PAIN RELIEF CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL P WILLEMSE D.C. (OWNER)
(908) 349-0342
Entity
Organization
Contact information
Practice address
2414 MORRIS AVE STE 101, UNION, NJ 07083-5708
(908) 349-0342
Mailing address
2414 MORRIS AVE STE 101, UNION, NJ 07083-5708
(908) 349-0342
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
225100000X
Physical Therapist
—
—
305S00000X
Point of Service
Primary
38MC00689200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38MC00689200
CHIROPRACTIC LICENSE
NJ
01
—
40QA01007300
PHYSICAL THERAPY LICENSE
NJ
Enumeration date
12/20/2011
Last updated
03/18/2022
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