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General NPI Number Information
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NPI Number | 1730468604
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Entity Type | Organization
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Legal Business Name | GANG MILLS CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 08/10/2011
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 481 S HAMILTON ST
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City | PAINTED POST
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State | NY
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Zip | 14870-8593
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Country | US
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Telephone | 607-725-3341
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Fax |
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Provider Business Mailing Address
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Address Line | 14 WILLOW DR
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City | PAINTED POST
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State | NY
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Zip | 14870-9303
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Country | US
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Telephone | 607-725-3341
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | DR. GILBERT MOLINGOU
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Credential | D.C.
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Telephone | 607-725-3341
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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 | X011919-1
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License Number State | NY
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