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General NPI Number Information
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NPI Number | 1841620879
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Entity Type | Organization
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Legal Business Name | ROCKLAND CHIROPRACTIC WELLNESS SERVICES
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 11/12/2013
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Provider Practice Location Address
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Address Line | 200 E ROUTE 59 SUITE 9
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City | NANUET
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State | NY
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Zip | 10954-2909
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Country | US
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Telephone | 845-507-0901
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E ROUTE 59 SUITE 9
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City | NANUET
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State | NY
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Zip | 10954-2909
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Country | US
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Telephone | 845-507-0901
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MITCHELL KAHN
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Credential | D.C.
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Telephone | 845-507-0901
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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 | 007392
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License Number State | NY
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