| NPI | 1114089737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY PAUL BOURGEOIS Owner Chiropractor 518-348-0287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NY X006369) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-08-22 |