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General NPI Number Information
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NPI Number | 1598169674
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Entity Type | Organization
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Legal Business Name | TWIN PINE FAMILY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 10/17/2014
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Provider Practice Location Address
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Address Line | 2609A STATE HIGHWAY 30A
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City | FONDA
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State | NY
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Zip | 12068-5955
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Country | US
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Telephone | 518-853-1567
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Fax | 518-853-1609
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Provider Business Mailing Address
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Address Line | 592 N GREEN RD
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City | SPRAKERS
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State | NY
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Zip | 12166-3202
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Country | US
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Telephone | 518-922-8624
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. SHARON ANN HULBERT
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Credential | D.C.
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Telephone | 518-853-1567
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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 | X010120
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License Number State | NY
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