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General NPI Number Information
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NPI Number | 1750653465
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Entity Type | Organization
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Legal Business Name | NETWORK SPINAL ANALYSIS FOR CHIROPRACTIC CARE PC
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Dates
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Enumeration Date | 01/27/2012
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Last Update Date | 03/06/2020
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Provider Practice Location Address
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Address Line | 222 MERRICK RD
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City | OCEANSIDE
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State | NY
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Zip | 11572-1429
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Country | US
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Telephone | 516-623-3195
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Fax | 516-623-1077
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Provider Business Mailing Address
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Address Line | 222 MERRICK RD
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City | OCEANSIDE
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State | NY
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Zip | 11572-1429
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Country | US
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Telephone | 516-623-3195
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Fax | 516-623-1077
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARY M JOHNSTON
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Credential | D.C.
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Telephone | 516-623-3195
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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 | X005570
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License Number State | NY
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