Individual
DR. JOHN MARK MISTRETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
6 MCMASTER ST STE 1, OWEGO, NY 13827-1029
(607) 687-2242
(607) 687-9128
Mailing address
6 MCMASTER ST STE 1, OWEGO, NY 13827-1029
(607) 687-2242
(607) 687-9128
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X005973-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000129776
EXCELLUS BC/BS
NY
Enumeration date
10/03/2006
Last updated
07/08/2007
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