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Organization
TACKETT CHIROPRACTIC, P.C.
Active
Organization
TACKETT CHIROPRACTIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM BERNARD TACKETT D.C. (PRES/OWNER)
(518) 798-4322
Entity
Organization
Contact information
Practice address
19 HOMER AVE, QUEENSBURY, NY 12804-2039
(518) 798-4322
(518) 743-8686
Mailing address
19 HOMER AVE, QUEENSBURY, NY 12804-2039
(518) 798-4322
(518) 743-8686
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X008214
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8248
CDPHP
NY
Enumeration date
08/03/2006
Last updated
08/22/2020
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