Organization
NORTHSIDE CHIROPRACTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA R GRANDAL (PARTNER)
(631) 544-0770
Entity
Organization
Contact information
Practice address
185 MAIN ST, KINGS PARK, NY 11754-2607
(631) 544-0770
Mailing address
185 MAIN ST, KINGS PARK, NY 11754-2607
(631) 544-0770
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
10/30/2007
Last updated
04/22/2008
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