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General NPI Number Information
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NPI Number | 1093910622
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Entity Type | Organization
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Legal Business Name | COSGROVE SMITH CHIROPRACTIC
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 01/30/2008
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Provider Practice Location Address
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Address Line | 340 CLEVELAND AVE
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City | HORNELL
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State | NY
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Zip | 14843-1004
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Country | US
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Telephone | 607-324-2444
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Fax | 607-324-2524
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Provider Business Mailing Address
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Address Line | PO BOX 358 340 CLEVELAND AVENUE
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City | HORNELL
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State | NY
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Zip | 14843-0358
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Country | US
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Telephone | 607-324-2444
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Fax | 607-324-2524
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUSAN COSGROVE
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Credential | DC
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Telephone | 607-324-2444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | X002893-1
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License Number State | NY
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