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General NPI Number Information
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NPI Number | 1417773763
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Entity Type | Organization
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Legal Business Name | SPRINGBURN CHIROPRACTIC PC
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 14075 ASH AVE STE 2B
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City | FLUSHING
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State | NY
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Zip | 11355-2789
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Country | US
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Telephone | 718-799-0912
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Fax | 718-799-0913
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Provider Business Mailing Address
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Address Line | 14075 ASH AVE STE 2B
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City | FLUSHING
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State | NY
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Zip | 11355-2789
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Country | US
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Telephone | 718-799-0912
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Fax | 718-779-0913
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | SUK MOON HWANG
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Credential | DC
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Telephone | 718-799-0212
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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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