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General NPI Number Information
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NPI Number | 1710963764
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Entity Type | Individual
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Provider Name | TINA MARIE NAGLE D.C.
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Gender | Female
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Dates
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Enumeration Date | 12/21/2005
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 204 W WATER ST SUITE 101
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City | PAINTED POST
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State | NY
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Zip | 14870-1131
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Country | US
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Telephone | 607-936-1552
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Fax | 607-936-1559
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Provider Business Mailing Address
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Address Line | 88 ROTARY ROAD EXT
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City | CHEMUNG
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State | NY
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Zip | 14825-9633
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Country | US
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Telephone | 607-529-3256
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | X007751-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC005900L
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License Number State | PA
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