Provider Demographics
NPI:1871348573
Name:EAGLE EYE CHIROPRACTIC KINESIOLOGY LLC
Entity type:Organization
Organization Name:EAGLE EYE CHIROPRACTIC KINESIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:D'AQUILA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-331-2200
Mailing Address - Street 1:16 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-2302
Mailing Address - Country:US
Mailing Address - Phone:203-331-2200
Mailing Address - Fax:
Practice Address - Street 1:70 PARK ST STE 101
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2960
Practice Address - Country:US
Practice Address - Phone:203-331-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-17
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service