# IMAGINE CHIROPRACTIC HEALTHCARE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Champion Performance and Rehabilitation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003118969
- **Authorized official:** DR. JAMES GUCCIARDI D.C. (OWNER)
- **Authorized official phone:** (631) 675-2758

## Contact information

- **Practice address:** 5 S JERSEY AVE, EAST SETAUKET, NY 11733-2045
- **Practice address phone:** (631) 675-2758
- **Practice address fax:** (631) 675-2760
- **Mailing address:** PO BOX 202, SAINT JAMES, NY 11780-0202
- **Mailing address phone:** (631) 675-2758
- **Mailing address fax:** (631) 675-2760

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 010407 | NY | Yes |

## Other

- **Enumeration date:** 11/29/2010
- **Last updated:** 04/03/2024