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Organization
LIVE WELL CHIROPRACTIC OF MASSAPEQUA PC
Active
Organization
LIVE WELL CHIROPRACTIC OF MASSAPEQUA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RENEE BOCCIO DC (PRESIDENT)
(516) 316-2032
Entity
Organization
Contact information
Practice address
2466 N JERUSALEM RD, NORTH BELLMORE, NY 11710-1107
(516) 316-2032
(352) 353-4717
Mailing address
2745 RUBY ROSE LN, SAINT CLOUD, FL 34771-9345
(516) 316-2032
(352) 353-4717
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X010111
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C101115W
WORKERS COMPENSATION
NY
Enumeration date
04/16/2008
Last updated
10/01/2024
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