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General NPI Number Information
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NPI Number | 1366873275
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Entity Type | Organization
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Legal Business Name | CLIFTON SPRINGS HOSPITAL & CLINIC
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Dates
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Enumeration Date | 12/02/2013
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Last Update Date | 12/02/2013
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Provider Practice Location Address
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Address Line | 2 COULTER RD INTEGRATIVE MEDICINE CENTER
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City | CLIFTON SPRINGS
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State | NY
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Zip | 14432-1122
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Country | US
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Telephone | 315-462-1350
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Fax | 315-462-7784
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Provider Business Mailing Address
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Address Line | 2 COULTER RD
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City | CLIFTON SPRINGS
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State | NY
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Zip | 14432-1122
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Country | US
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Telephone | 315-462-9561
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Fax | 315-462-7784
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | DONNA SMITH
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Credential | RN
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Telephone | 315-462-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 022094
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 015013
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 025611
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 004665
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License Number State | NY
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