| NPI | 1134521727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICKA JENSEN Office Manager 518-869-3884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X009067-1) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 019993-1) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2014-10-29 |