Individual
DR. DENNIS MJ HOMACK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DC, MS, CCSP
Contact information
Practice address
2360 STATE ROUTE 89, SENECA FALLS, NY 13148-9425
(315) 568-3157
(315) 568-3017
Mailing address
27 VAN RENSSALAER ST, SENECA FALLS, NY 13148-1705
(315) 568-8680
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
X08680-2
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11122804
CAQH UNIVERSAL CREDENTIAL
NY
01
—
C-08680-2
WORKERS COMP
NY
Enumeration date
05/09/2006
Last updated
07/08/2007
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