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Organization
WYNANTSKILL CHIROPRACTIC PC
Active
Organization
WYNANTSKILL CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN J O'BRIEN DC (DOCTOR / OWNER)
(518) 286-3060
Entity
Organization
Contact information
Practice address
492 PAWLING AVE, TROY, NY 12180-5834
(518) 286-3060
(518) 286-3044
Mailing address
492 PAWLING AVE, TROY, NY 12180-5834
(518) 286-3060
(518) 286-3044
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X0066141
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10021222
CDPHP
NY
01
—
607980
MVP
NY
01
—
C066144
WORKERS' COMPENSATION
NY
01
—
X54101
BLUE CROSS BLUE SHIELD
—
Enumeration date
12/28/2006
Last updated
11/12/2012
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