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General NPI Number Information
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NPI Number | 1538989405
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Entity Type | Organization
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Legal Business Name | ADVANTAGE CHIROPRACTIC AND SPORTS REHAB
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 344 W 51ST ST
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City | NEW YORK
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State | NY
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Zip | 10019-6402
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Country | US
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Telephone | 212-269-0300
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Fax | 866-347-0843
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Provider Business Mailing Address
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Address Line | 344 W 51ST ST
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City | NEW YORK
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State | NY
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Zip | 10019-6402
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Country | US
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Telephone | 212-269-0300
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Fax | 866-347-0843
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Authorized Official
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Title or Position | OWNER / PROVIDER
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Name | DR. MITCHELL B GREEN
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Credential | DC, DACRB
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Telephone | 212-269-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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