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Organization
WELLNESS SPORT & SPINE CHIROPRACTIC PLLC
Active
Organization
WELLNESS SPORT & SPINE CHIROPRACTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM C MILLER DC (DOCTOR)
(607) 786-3601
Entity
Organization
Contact information
Practice address
130 FRONT ST, VESTAL, NY 13850-1562
(607) 786-3601
(607) 834-7029
Mailing address
130 FRONT ST, VESTAL, NY 13850-1562
(607) 786-3601
(607) 834-7029
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X009961-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000143666
EXCELLUS BC BS
NY
01
—
1003840711
NPI INDIVIDUAL
NY
01
—
100651380167
CDPHP
NY
01
—
5734880001
DMEPOS
NY
01
—
648821
UNITED HEALTH CARE
NY
Enumeration date
01/18/2007
Last updated
06/17/2014
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