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General NPI Number Information
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NPI Number | 1124997994
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Entity Type | Organization
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Legal Business Name | SOUTH SHORE CHIROPRACTIC AND PHYSICAL THERAPY
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Dates
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Enumeration Date | 10/31/2025
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 1646 BRENTWOOD RD
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City | BRENTWOOD
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State | NY
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Zip | 11717-5534
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Country | US
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Telephone | 631-231-5200
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Fax | 631-231-4431
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Provider Business Mailing Address
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Address Line | 1646 BRENTWOOD RD
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City | BRENTWOOD
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State | NY
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Zip | 11717-5534
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Country | US
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Telephone | 631-231-5200
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Fax | 631-231-4431
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL SMALL
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Credential | DC
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Telephone | 631-231-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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