WELLNESS SPORT & SPINE CHIROPRACTIC PLLC NPI 1417009283

NPI Information

NPI: 1417009283
Provider Name: WELLNESS SPORT & SPINE CHIROPRACTIC PLLC
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
130 FRONT ST
VESTAL, NY
ZIP 13850
Phone: (607) 786-3601
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WELLNESS SPORT & SPINE CHIROPRACTIC PLLC is a chiropractor in Vestal, NY. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. WELLNESS SPORT & SPINE CHIROPRACTIC PLLC NPI is 1417009283. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

130 FRONT ST
VESTAL, NY
ZIP 13850-562
Phone: (607) 786-3601
Fax: (607) 834-7029

The provider's authorized official is Kim C Miller .
The authorized official title is Doctor and has the following contact phone number (607) 786-3601.

The enumeration date for this NPI number is 1/18/2007 and was last updated on 6/17/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor		X009961-1	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5734880001	OTHER	NEW YORK	DMEPOS
2	648821	OTHER	NEW YORK	UNITED HEALTH CARE
3	1003840711	OTHER	NEW YORK	NPI INDIVIDUAL
4	000143666	OTHER	NEW YORK	EXCELLUS BC BS
5	100651380167	OTHER	NEW YORK	CDPHP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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