Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 38MC00779900 | NJ |
NPI | 1033794532 |
---|---|
Provider Name | Spencer Corbin |
First Address | Franklin Lakes, NJ 07417-1306 |
Second Address | Midland Park, NJ 07432-1815 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2021 |
Last Update Date | 16/03/2021 |