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General NPI Number Information
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NPI Number | 1891571568
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Entity Type | Organization
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Legal Business Name | LIFEPOWER CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 09/07/2023
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 135 N COURT ST
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City | WAMPSVILLE
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State | NY
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Zip | 13163-7713
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Country | US
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Telephone | 315-280-0586
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Fax | 315-282-2332
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Provider Business Mailing Address
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Address Line | PO BOX 13
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City | WAMPSVILLE
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State | NY
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Zip | 13163-0013
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Country | US
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Telephone | 315-280-0586
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Fax | 315-282-2332
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Authorized Official
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Title or Position | OWNER/HEAD DOCTOR
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Name | DR. SHERIDAN A MISH
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Credential | D.C.
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Telephone | 315-280-0586
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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 |
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