Healthcare Provider Details

I. General information

NPI: 1922444124
Provider Name (Legal Business Name): ALL ISLAND CHIROPRACTIC & PHYSICAL THERAPY CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2013
Last Update Date: 05/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 E MAIN ST
BAY SHORE NY
11706-8301
US

IV. Provider business mailing address

36 E MAIN ST
BAY SHORE NY
11706-8301
US

V. Phone/Fax

Practice location:
  • Phone: 631-665-3714
  • Fax: 631-665-3749
Mailing address:
  • Phone: 631-665-3714
  • Fax: 631-665-3749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX007836
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number025828-1
License Number StateNY

VIII. Authorized Official

Name: DR. CRAIG SELZER
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 631-665-3714