# MODERN CHIROPRACTIC PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396750972
- **Authorized official:** DIANA VAVIKOVA D.C. (OWNER)
- **Authorized official phone:** (917) 817-9244

## Contact information

- **Practice address:** 3062 BRIGHTON 3RD ST, BROOKLYN, NY 11235-7409
- **Practice address phone:** (917) 817-9244
- **Practice address fax:** (718) 743-9680
- **Mailing address:** 3062 BRIGHTON 3RD ST, BROOKLYN, NY 11235-7409
- **Mailing address phone:** (917) 817-9244
- **Mailing address fax:** (718) 743-9680

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | X009246 | NY | Yes |

## Other

- **Enumeration date:** 07/30/2006
- **Last updated:** 12/11/2007