Organization
PRIME CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONG SUN PARK D.C. (PRESIDENT)
(201) 669-0336
Entity
Organization
Contact information
Practice address
118 BROAD AVE STE 9, PALISADES PARK, NJ 07650-2717
(201) 313-1122
(201) 941-1157
Mailing address
118 BROAD AVE STE 9, PALISADES PARK, NJ 07650-2717
(201) 313-1122
(201) 941-1157
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00694400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38MC00694400
NJ LICENSE NUMBER
NJ
Enumeration date
05/21/2014
Last updated
05/21/2014
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