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General NPI Number Information
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NPI Number | 1629263488
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Entity Type | Organization
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Legal Business Name | CATSKILL MOUNTAIN CHIROPRACTIC, PC
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Dates
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Enumeration Date | 09/13/2007
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Last Update Date | 07/20/2017
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Provider Practice Location Address
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Address Line | 41 FIVE MILE WOODS RD
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City | CATSKILL
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State | NY
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Zip | 12414-5921
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Country | US
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Telephone | 518-943-9454
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Fax | 518-943-0623
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Provider Business Mailing Address
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Address Line | 41 FIVE MILE WOODS RD
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City | CATSKILL
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State | NY
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Zip | 12414-5921
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Country | US
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Telephone | 518-943-9454
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Fax | 518-943-0623
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Authorized Official
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Title or Position | PARTNER
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Name | KAREN S VANWIE
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Credential | DC
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Telephone | 518-943-9454
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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 | 005260-1
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License Number State | NY
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