Provider Demographics
NPI:1710286380
Name:CARRUTHERS, NICHOLAS CLARK (DC)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:CLARK
Last Name:CARRUTHERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 GROVE ST
Mailing Address - Street 2:PMB 62479
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302
Mailing Address - Country:US
Mailing Address - Phone:732-810-1084
Mailing Address - Fax:888-743-1260
Practice Address - Street 1:344 GROVE ST
Practice Address - Street 2:PMB 62479
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302
Practice Address - Country:US
Practice Address - Phone:732-810-1084
Practice Address - Fax:888-743-1260
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00696500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor