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General NPI Number Information
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NPI Number | 1508657313
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Entity Type | Organization
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Legal Business Name | SPINE NYC CHIROPRACTIC PC
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 225 BROADWAY STE 1630
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City | NEW YORK
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State | NY
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Zip | 10007-3760
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Country | US
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Telephone | 551-359-3405
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Fax |
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Provider Business Mailing Address
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Address Line | 225 BROADWAY STE 1630
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City | NEW YORK
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State | NY
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Zip | 10007-3760
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Country | US
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Telephone | 551-359-3405
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SANG BUM KIM
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Credential | DC
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Telephone | 551-359-3405
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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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