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Organization
LIFE CHIROPRACTIC
Active
Organization
LIFE CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY COHEN (SOLE PROPRIETOR)
(718) 366-4546
Entity
Organization
Contact information
Practice address
714 SENECA AVE, RIDGEWOOD, NY 11385-2895
(718) 366-4546
Mailing address
134 RITA DR, CORTLANDT MANOR, NY 10567-2606
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
X006583-1
NY
Other
Enumeration date
12/18/2006
Last updated
03/10/2008
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