Healthcare Provider Details

I. General information

NPI: 1649197369
Provider Name (Legal Business Name): SPRINGBROOK WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5588 STATE HIGHWAY 7
ONEONTA NY
13820-2081
US

IV. Provider business mailing address

5588 STATE HIGHWAY 7
ONEONTA NY
13820-2081
US

V. Phone/Fax

Practice location:
  • Phone: 607-788-3528
  • Fax:
Mailing address:
  • Phone: 607-788-3528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MISS JENNY INEZ FERGUSON
Title or Position: CLINIC ADMINISTRATOR
Credential: MBA
Phone: 607-788-3528