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General NPI Number Information
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NPI Number | 1215711361
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Entity Type | Organization
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Legal Business Name | CATSKILL VALLEY CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 08/21/2023
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 20 COUNTRY ESTATES RD
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City | GREENVILLE
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State | NY
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Zip | 12083-3414
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Country | US
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Telephone | 518-860-9555
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Fax |
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Provider Business Mailing Address
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Address Line | 20 COUNTRY ESTATES RD
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City | GREENVILLE
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State | NY
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Zip | 12083-3414
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELIZABETH BOOMHOWER
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Credential |
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Telephone | 518-860-9555
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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 |
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License Number State |
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