Individual
JOSEPH J LICITRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
300 BROADACRES DR STE 126, BLOOMFIELD, NJ 07003-3153
(973) 470-0632
(973) 893-8259
Mailing address
300 BROADACRES DR STE 126A, BLOOMFIELD, NJ 07003-3153
(973) 470-0632
(973) 893-8259
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00224400
NJ
Other
Enumeration date
07/22/2005
Last updated
09/16/2022
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