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General NPI Number Information
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NPI Number | 1891948345
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Entity Type | Organization
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Legal Business Name | MCKENNA FAMILY CHIROPRACTIC P.C.
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 604 FIFTH AVE
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City | PELHAM
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State | NY
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Zip | 10803-3704
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Country | US
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Telephone | 914-738-4460
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Fax | 914-738-6299
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Provider Business Mailing Address
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Address Line | 604 FIFTH AVE
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City | PELHAM
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State | NY
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Zip | 10803-3704
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Country | US
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Telephone | 914-738-4460
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Fax | 914-738-6299
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM P MCKENNA
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Credential | D.C.
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Telephone | 914-738-4460
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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 | X009822
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License Number State | NY
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