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Organization
HEAD TO TOE CHIROPRACTIC, PLLC
Active
Organization
HEAD TO TOE CHIROPRACTIC, PLLC
Active
Other names
Optimum Chiropractic Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN TARA MACKEY D.C. (OWNER)
(631) 689-0049
Entity
Organization
Contact information
Practice address
2500 NESCONSET HIGHWAY, BUILDING 9B, STONY BROOK, NY 11790
(631) 689-0049
(631) 689-0071
Mailing address
2500 NESCONSET HIGHWAY, BUILDING 9B, STONY BROOK, NY 11790
(631) 689-0049
(631) 689-0071
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X007538-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5899840
GHI
—
01
—
C075384
WORKERS COMPENSATION
NY
01
—
X97331
BC/BS
—
Enumeration date
02/27/2017
Last updated
02/27/2017
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