Healthcare Provider Details

I. General information

NPI: 1366458101
Provider Name (Legal Business Name): WALENTIN CHIROPRACTIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 05/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 QUAKER AVE
CORNWALL NY
12518-2113
US

IV. Provider business mailing address

16 QUAKER AVE
CORNWALL NY
12518-2113
US

V. Phone/Fax

Practice location:
  • Phone: 845-534-9331
  • Fax:
Mailing address:
  • Phone: 845-534-9331
  • Fax: 845-534-7854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX011024
License Number StateNY

VIII. Authorized Official

Name: DR. ANTHONY L MANOY
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 845-534-9331