MEDICARE: PEET FAMILY CHIROPRACTIC, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	X004107-1	NY

General Provider Information

NPI Number	:	1629388749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEET FAMILY CHIROPRACTIC, PC

Provider Business Mailing Address
First Line	:	2 SPRING SQUARE BUSINESS PARK
Second Line	:
City	:	NEWBURGH
State	:	NY
Zip	:	12550-2567
Country	:	US
Telephone Number	:	845-566-1313
Fax Number	:	845-566-1379

Provider Business Practice Location Address
First Line	:	2 SPRING SQUARE BUSINESS PARK
Second Line	:
City	:	NEWBURGH
State	:	NY
Zip	:	12550-2567
Country	:	US
Telephone Number	:	845-566-1313
Fax Number	:	845-566-1379

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PARRY A PEET
Credential	:	DC
Telephone Number	:	845-566-1313

Provider Enumeration Date	:	10/08/2010
Last Update Date	:	11/09/2015

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