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General NPI Number Information
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NPI Number | 1730632621
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Entity Type | Organization
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Legal Business Name | TS CHIROPRACTIC WELLNESS, P.C.
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Dates
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Enumeration Date | 07/27/2016
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Last Update Date | 07/27/2016
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Provider Practice Location Address
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Address Line | 1735 PITKIN AVE.
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City | BROOKLYN
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State | NY
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Zip | 11212-6603
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Country | US
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Telephone | 718-490-0557
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Fax |
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Provider Business Mailing Address
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Address Line | 15-41 212TH STREET
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City | BAYSIDE
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State | NY
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Zip | 11360-1109
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Country | US
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Telephone | 718-490-0557
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. TARA SMITH
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Credential | D.C.
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Telephone | 718-490-0557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | X009921
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License Number State | NY
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