Back Pain Rehab Center for Treatment of Back Pain LLC

Organization Active NPI Chiropractor · Park Ridge, NJ

NPI 1639458094 · NPPES record last updated Aug 16, 2011

Key facts

NPI
1639458094
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
License
38MC00430900 (NJ)
Legal business name
BACK PAIN REHAB CENTER FOR TREATMENT OF BACK PAIN LLC
Practice address
12 Wortendyke Rd
Park Ridge, NJ 07656-2046
Phone
(201) 750-7246
NPI assigned
Aug 16, 2011
Organization subpart
No

Authorized official

Name
Dr. Glenn N Collazo, D.C.
Title
Director
Phone
(201) 750-7246

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X 38MC00430900 NJ Yes

Addresses

Primary practice location

12 Wortendyke Rd
Park Ridge, NJ 07656-2046

Mailing address

12 Wortendyke Rd
Park Ridge, NJ 07656-2046
Phone (201) 750-7246

Other names

  • BACK PAIN REHAB LLC Doing business as

Other providers in Park Ridge, NJ

All providers in Park Ridge, NJ · Chiropractor in New Jersey

Sources for this page

Verify at the official NPI Registry.