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General NPI Number Information
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NPI Number | 1447336995
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Entity Type | Organization
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Legal Business Name | IWANIEC CHIROPRACTIC PC
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 133 COLUMBIA TURNPIKE
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City | RENSSELAER
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State | NY
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Zip | 12144
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Country | US
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Telephone | 518-432-7951
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Fax | 518-432-7421
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Provider Business Mailing Address
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Address Line | 133 COLUMBIA TURNPIKE
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City | RENSSELAER
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State | NY
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Zip | 12144
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Country | US
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Telephone | 518-432-7951
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Fax | 518-432-7421
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MELISSA A MAISONET
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Credential |
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Telephone | 518-432-7951
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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 | NY
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