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General NPI Number Information
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NPI Number | 1740305531
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Entity Type | Organization
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Legal Business Name | SOUTHSIDE CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 531 SOUTHSIDE DR
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City | ONEONTA
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State | NY
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Zip | 13820-3211
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Country | US
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Telephone | 607-433-9661
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Fax | 607-643-0306
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Provider Business Mailing Address
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Address Line | 531 SOUTHSIDE DR
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City | ONEONTA
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State | NY
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Zip | 13820-3211
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Country | US
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Telephone | 607-433-9661
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Fax | 607-643-0306
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Authorized Official
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Title or Position | FININICIAL MANAGER
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Name | MS. APRIL DAWN HILLIER
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Credential |
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Telephone | 607-433-9661
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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 |
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License Number State | NY
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