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General NPI Number Information
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NPI Number | 1750809273
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Entity Type | Organization
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Legal Business Name | ADIRONDACK SPINE AND SPORTS CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 09/05/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 484 GLEN ST STE B
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City | GLENS FALLS
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State | NY
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Zip | 12801-3194
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Country | US
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Telephone | 518-741-7016
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Fax |
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Provider Business Mailing Address
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Address Line | 96 W NOTRE DAME ST
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City | GLENS FALLS
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State | NY
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Zip | 12801-2723
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Country | US
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Telephone | 845-264-1451
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL BORIS FORLINI
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Credential | DC
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Telephone | 518-741-7016
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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 | 012909
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License Number State | NY
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