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General NPI Number Information
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NPI Number | 1619641727
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Entity Type | Organization
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Legal Business Name | CLIFTON PARK CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 08/03/2021
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Provider Practice Location Address
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Address Line | 1789 ROUTE 9
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City | HALFMOON
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State | NY
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Zip | 12065-2458
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Country | US
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Telephone | 518-930-0049
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Fax |
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Provider Business Mailing Address
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Address Line | 22 SWEETBRIAR DR
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City | GANSEVOORT
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State | NY
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Zip | 12831-2526
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Country | US
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Telephone | 484-336-6635
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CAROLYN DRISCOLL
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Credential | DC
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Telephone | 484-336-6635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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