| Life Clinic Of Nj Dc Pa | |
|
7 Forrestal Road S, Plainsborough, NJ 08536 | |
| (612) 868-6894 | |
| Not Available |
| Full Name | Life Clinic Of Nj Dc Pa |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 7 Forrestal Road S, Plainsborough, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720575178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 38MC00735800 (New Jersey) | Primary |
| Provider Name | Logan W Luzadder |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1356894117 PECOS PAC ID: 9133494008 Enrollment ID: I20171003003937 |
| Provider Name | Ian Raphael Barry |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1417412966 PECOS PAC ID: 1759621543 Enrollment ID: I20190313002517 |
| Provider Name | Roger Mitchell |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1326562034 PECOS PAC ID: 6103198692 Enrollment ID: I20190722003436 |
| Provider Name | Jonathan M Segreti |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1114485398 PECOS PAC ID: 2365872801 Enrollment ID: I20200423001330 |
| Provider Name | Vincent J Martino |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1962538223 PECOS PAC ID: 1456798073 Enrollment ID: I20240319001302 |
| Provider Name | John Z Didomenico |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1164808481 PECOS PAC ID: 4082141684 Enrollment ID: I20241220000718 |
| Mailing Address | Practice Location Address |
|---|---|
| Life Clinic Of Nj Dc Pa Po Box 549, Chanhassen, MN 55317-0549 Ph: (612) 868-6894 | Life Clinic Of Nj Dc Pa 7 Forrestal Road S, Plainsborough, NJ 08536 Ph: (612) 868-6894 |