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General NPI Number Information
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NPI Number | 1073068136
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Entity Type | Organization
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Legal Business Name | MT HOPE CHIROPRACTIC WELLNESS, PLLC
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Dates
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Enumeration Date | 08/18/2016
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Last Update Date | 10/13/2018
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Provider Practice Location Address
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Address Line | 1174 MOUNT HOPE AVE
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City | ROCHESTER
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State | NY
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Zip | 14620-2911
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Country | US
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Telephone | 585-329-4298
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Fax |
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Provider Business Mailing Address
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Address Line | 1174 MOUNT HOPE AVE
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City | ROCHESTER
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State | NY
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Zip | 14620-2911
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Country | US
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Telephone | 585-329-4298
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Fax |
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | DR. ROBERT M DENERO
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Credential | DC
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Telephone | 585-329-4298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 012218
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 012556
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License Number State | NY
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