State Line Chiropractic and Wellness Center Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00514100 Issued in NJ

Legal business name

STATE LINE CHIROPRACTIC AND WELLNESS CENTER INC

Practice address

480 Memorial Pkwy
Phillipsburg, NJ 08865-1575

Phone

(908) 454-8808

Fax

(908) 998-4762

NPI assigned

Apr 24, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

James William Mattison Jr., DC

Title

President

Phone

(908) 454-8808

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373846400000",
    "number": "1346469822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 MEMORIAL PKWY",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651575",
            "telephone_number": "908-454-8808",
            "fax_number": "908-998-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 MEMORIAL PKWY",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651575",
            "telephone_number": "908-454-8808",
            "fax_number": "908-998-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE LINE CHIROPRACTIC AND WELLNESS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2013-07-15",
        "status": "A",
        "authorized_official_last_name": "MATTISON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-454-8808",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00514100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "087692",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Phillipsburg, NJ
• Providers in Phillipsburg, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.