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General NPI Number Information
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NPI Number | 1831344472
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Entity Type | Organization
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Legal Business Name | ADVANCED FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 11/24/2008
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Last Update Date | 11/24/2008
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Provider Practice Location Address
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Address Line | 219 W MAIN ST
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City | MONTOUR FALLS
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State | NY
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Zip | 14865
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Country | US
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Telephone | 607-535-7080
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 447 219 W MAIN ST
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City | MONTOUR FALLS
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State | NY
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Zip | 14865
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Country | US
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Telephone | 607-535-7080
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT H BERRY JR.
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Credential | DC
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Telephone | 607-936-7871
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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 | X008606-1
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License Number State | NY
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