Provider Demographics
NPI:1518945682
Name:ADAM, GEORGE CLEMENT (DC)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:CLEMENT
Last Name:ADAM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W FRONT ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1155
Mailing Address - Country:US
Mailing Address - Phone:732-741-7888
Mailing Address - Fax:732-741-7855
Practice Address - Street 1:210 W FRONT ST
Practice Address - Street 2:SUITE 203
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1155
Practice Address - Country:US
Practice Address - Phone:732-741-7888
Practice Address - Fax:732-741-7855
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00523100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor