Provider Demographics
NPI:1447438916
Name:TLC FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:TLC FAMILY CHIROPRACTIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LADAGONA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-409-3445
Mailing Address - Street 1:1200 ROUTE 9 S
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3329
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:732-409-7344
Practice Address - Street 1:1200 ROUTE 9 S
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3329
Practice Address - Country:US
Practice Address - Phone:732-409-3445
Practice Address - Fax:732-409-7344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC01775111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ121959Medicare PIN
NJT52030Medicare UPIN