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General NPI Number Information
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NPI Number | 1982996336
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Entity Type | Organization
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Legal Business Name | WOROB CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 1212 TRUMANSBURG RD
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City | ITHACA
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State | NY
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Zip | 14850-1314
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Country | US
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Telephone | 607-288-2205
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Fax | 607-793-9464
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Provider Business Mailing Address
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Address Line | 1212 TRUMANSBURG RD
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City | ITHACA
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State | NY
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Zip | 14850-1314
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Country | US
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Telephone | 607-288-2205
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Fax | 607-793-9464
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Authorized Official
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Title or Position | OWNER
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Name | AMMITAI WOROB
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Credential | D. C.
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Telephone | 607-288-2205
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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 | 011697
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License Number State | NY
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