# BROOKHAVEN SPINE & SPORTS CHIROPRACTIC

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

## Provider details

- **NPI number:** 1801550769
- **Authorized official:** MATTHEW JOSEPH VISO DC (PARTNER)
- **Authorized official phone:** (917) 921-0054

## Contact information

- **Practice address:** 239 E MAIN ST, PATCHOGUE, NY 11772-3105
- **Practice address phone:** (631) 627-6300
- **Mailing address:** 239 E MAIN ST, PATCHOGUE, NY 11772-3105
- **Mailing address phone:** (631) 627-6300

## Taxonomy

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

## Other

- **Enumeration date:** 10/27/2021
- **Last updated:** 10/27/2021