Organization
DIVINE CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHLEEN CAREY CLARKIN-DEDIO D.C. (OWNER)
(631) 384-2023
Entity
Organization
Contact information
Practice address
465 ROUTE 25A, SUITE 1, MILLER PLACE, NY 11764
(631) 384-2023
Mailing address
465 ROUTE 25A, SUITE 1, MILLER PLACE, NY 11764
(631) 384-2023
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X011437-1
NY
Other
Enumeration date
03/13/2012
Last updated
03/13/2012
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