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Organization
WATERBURY CHIROPRACTIC
Active
Organization
WATERBURY CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA RUTH WATERBURY DC (OWNER)
(518) 279-0183
Entity
Organization
Contact information
Practice address
TAMARAC PLAZA, 3991 RTE 2, CROPSEYVILLE, NY 12052
(518) 279-0183
Mailing address
TAMARAC PLAZA, 3991 RTE 2, CROPSEYVILLE, NY 12052
(518) 279-0183
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X009923-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10058438
CDPHP
NY
01
—
CO9923-6B
WORKERS COMP
NY
Enumeration date
04/17/2007
Last updated
08/22/2020
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