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General NPI Number Information
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NPI Number | 1164756250
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Entity Type | Organization
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Legal Business Name | BACK IN MOTION CHIROPRACTIC PC
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Dates
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Enumeration Date | 09/23/2009
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Last Update Date | 10/06/2009
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Provider Practice Location Address
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Address Line | 24 HAMILTON ST SUITE 4
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-4226
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Country | US
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Telephone | 518-581-7246
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Fax | 518-581-4067
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Provider Business Mailing Address
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Address Line | 24 HAMILTON ST SUITE 4
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-4226
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Country | US
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Telephone | 518-581-7246
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Fax | 518-581-4067
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEITH F CAVAYERO
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Credential | D.C.
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Telephone | 518-581-7246
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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 | X006165
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License Number State | NY
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