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Organization

SYRACUSE FAMILY CHIROPRACTIC LLC

Active
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Organization

SYRACUSE FAMILY CHIROPRACTIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PETER GEORGE NICKLESS DC (OWNER/PROVIDER)
(315) 761-6311
Entity
Organization

Contact information

Practice address
4000 MEDICAL CENTER DRIVE, SUITE 301, FAYETTEVILLE, NY 13066
(315) 761-6311
Mailing address
7810 BULL ST, BRIDGEPORT, NY 13030-8418
(315) 761-6311

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
111NI0013X
Independent Medical Examiner Chiropractor
111NN1001X
Nutrition Chiropractor
111NS0005X
Sports Physician Chiropractor

Other

Enumeration date
07/20/2026
Last updated
07/20/2026
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