Healthcare Provider Details

I. General information

NPI: 1942857875
Provider Name (Legal Business Name): WURTSBORO ACUPUNCTURE, CHIROPRACTIC AND PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SULLIVAN ST
WURTSBORO NY
12790-8226
US

IV. Provider business mailing address

PO BOX 490
WURTSBORO NY
12790-0490
US

V. Phone/Fax

Practice location:
  • Phone: 845-733-5022
  • Fax:
Mailing address:
  • Phone: 845-733-5022
  • Fax: 845-733-5022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JACEK KURA
Title or Position: OWNER/MEMBER
Credential: MSPT, DC, MSA
Phone: 845-733-5022