Healthcare Provider Details

I. General information

NPI: 1528135563
Provider Name (Legal Business Name): BATH CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 03/24/2022
Certification Date: 03/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6723 SR 415
BATH NY
14810
US

IV. Provider business mailing address

6723 STATE ROUTE 415
BATH NY
14810-7709
US

V. Phone/Fax

Practice location:
  • Phone: 607-776-2741
  • Fax: 607-776-0061
Mailing address:
  • Phone: 607-776-2741
  • Fax: 607-776-0061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS JOHN FRANKIE
Title or Position: OWNER CHIROPRACTOR
Credential: DC
Phone: 607-776-2741