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General NPI Number Information
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NPI Number | 1952615874
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Entity Type | Organization
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Legal Business Name | NORTH MERRICK CHIROPRACTIC
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Dates
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Enumeration Date | 08/03/2010
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Last Update Date | 08/03/2010
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Provider Practice Location Address
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Address Line | 399 MERRICK AVE
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City | MERRICK
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State | NY
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Zip | 11566-2723
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Country | US
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Telephone | 516-867-7096
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Fax |
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Provider Business Mailing Address
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Address Line | 399 MERRICK AVE
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City | MERRICK
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State | NY
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Zip | 11566-2723
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Country | US
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Telephone | 516-867-7096
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Fax |
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Authorized Official
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Title or Position | OFFICER MANAGER
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Name | MRS. TONILYNN HOOVER
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Credential |
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Telephone | 516-867-7096
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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 | X0067101
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License Number State | NY
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