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General NPI Number Information
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NPI Number | 1508028416
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Entity Type | Organization
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Legal Business Name | TOMPKINS COMMUNITY CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 435 FRANKLIN ST SUITE 206
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City | ITHACA
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State | NY
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Zip | 14850-3570
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Country | US
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Telephone | 607-257-6217
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Fax | 607-257-6847
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Provider Business Mailing Address
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Address Line | 435 FRANKLIN ST SUITE 206
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City | ITHACA
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State | NY
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Zip | 14850-3570
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Country | US
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Telephone | 607-257-6217
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Fax | 607-257-6847
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. RANDALL H. COREY
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Credential | D.C.
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Telephone | 607-257-6217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | X005048
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License Number State | NY
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