Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 611200 | NJ |
NPI | 1396825436 |
---|---|
Provider Name | Dr. Wayne Creyaufmiller |
First Address | Cherry Hill, NJ 08034-2207 |
Second Address | Cherry Hill, NJ 08034-2207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 08/07/2007 |