Back To Health Chiropractic, P.C
Chiropractor in Staten Island, NY. Organization (NPI-2).
NPI number1104097393
StatusActive
Last updated in NPPESApr 28, 2009
Details
- NPI
- 1104097393
- Entity type
- Organization (NPI-2)
- Legal business name
- Back To Health Chiropractic, P.C
- Organization subpart
- No
- Enumeration date
- Mar 17, 2008
- Last updated
- Apr 28, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | x009001 | NY | Yes |
Practice location
6659 Amboy RdStaten Island, NY 10309-3125
Phone 718-605-2225 · Fax 718-966-5630
Mailing address
6659 Amboy RdStaten Island, NY 10309-3125
Phone 718-605-2225 · Fax 718-966-5630
Authorized official
Anthony Stephen Mandracchia
Owner
7186052225
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