Healthcare Provider Details

I. General information

NPI: 1720041346
Provider Name (Legal Business Name): SPRING VALLEY CHIROPRACTIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 OLD NYACK TPKE
SPRING VALLEY NY
10977-5741
US

IV. Provider business mailing address

256 OLD NYACK TPKE
SPRING VALLEY NY
10977-5741
US

V. Phone/Fax

Practice location:
  • Phone: 845-426-3701
  • Fax: 845-426-3702
Mailing address:
  • Phone: 845-426-3701
  • Fax: 845-426-3702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT BONNETT JR.
Title or Position: SECRETARY
Credential: D.C.
Phone: 845-426-3701