Healthcare Provider Details

I. General information

NPI: 1043513989
Provider Name (Legal Business Name): BODENSTEIN CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2010
Last Update Date: 12/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4895 STATE ROUTE 52
JEFFERSONVILLE NY
12748
US

IV. Provider business mailing address

PO BOX 48
JEFFERSONVILLE NY
12748-0048
US

V. Phone/Fax

Practice location:
  • Phone: 845-482-4442
  • Fax: 845-482-4450
Mailing address:
  • Phone: 845-482-4442
  • Fax: 845-482-4450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. DAVID ALLEN SAGER
Title or Position: SOLE PROPRIETOR/OWNER
Credential: D.C.
Phone: 845-482-4442