Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 38MC00506300 | NJ |
NPI | 1942384540 |
---|---|
Provider Name | Dr. Christopher J Bott |
First Address | Ship Bottom, NJ 08008-4634 |
Second Address | Ship Bottom, NJ 08008-4634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 23/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U71649 | (02) | NJ |