| NPI | 1083622336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BERNARD TACKETT Pres/Owner 518-798-4322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X008214) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2020-08-22 |