# MOUNTAIN VALLEY CHIROPRACTIC, PLLC

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

## Provider details

- **NPI number:** 1558411090
- **Authorized official:** DR. JONATHAN GREGORY MULHOLLAND D.C. (MANAGING MEMBER)
- **Authorized official phone:** (518) 873-6744

## Contact information

- **Practice address:** 1 WOODRUFF LN, ELIZABETHTOWN, NY 12932-0605
- **Practice address phone:** (518) 873-6744
- **Practice address fax:** (518) 873-2744
- **Mailing address:** PO BOX 605, 1 WOODRUFF LN, ELIZABETHTOWN, NY 12932-0605
- **Mailing address phone:** (518) 873-6744
- **Mailing address fax:** (518) 873-2744

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | X009992 | NY | Yes |

## Other

- **Enumeration date:** 01/10/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02729000 | — | NY |