Provider Demographics
NPI:1669802690
Name:FALLON CHIROPRACTIC
Entity type:Organization
Organization Name:FALLON CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:DELIKAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-801-7781
Mailing Address - Street 1:186 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-1385
Mailing Address - Country:US
Mailing Address - Phone:908-735-4589
Mailing Address - Fax:908-735-5878
Practice Address - Street 1:186 CENTER ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809-1385
Practice Address - Country:US
Practice Address - Phone:908-735-4589
Practice Address - Fax:908-735-5878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty