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General NPI Number Information
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NPI Number | 1952424426
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Entity Type | Organization
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Legal Business Name | BC CHIROPRACTIC OFFICES PC
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 11/16/2011
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Provider Practice Location Address
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Address Line | 5500 BARTEL RD
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City | BREWERTON
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State | NY
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Zip | 13029-8792
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Country | US
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Telephone | 315-676-4655
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Fax | 315-655-4044
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Provider Business Mailing Address
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Address Line | 5500 BARTEL RD
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City | BREWERTON
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State | NY
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Zip | 13029-8792
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Country | US
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Telephone | 315-676-4655
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Fax | 315-655-4044
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARY ANNE TAYLOR-LAMB
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Credential | DC
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Telephone | 315-676-4655
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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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