Organization
HEAD TO TOE CHIROPRACTIC, PLLC
Active
Other names
Optimum Chiropractic Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN TARA MACKEY D.C. (OWNER)
(631) 689-0049
Entity
Organization
Contact information
Practice address
2500 NESCONSET HIGHWAY, BUILDING 9B, STONY BROOK, NY 11790
(631) 689-0049
(631) 689-0071
Mailing address
2500 NESCONSET HIGHWAY, BUILDING 9B, STONY BROOK, NY 11790
(631) 689-0049
(631) 689-0071
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X007538-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5899840
GHI
—
01
—
C075384
WORKERS COMPENSATION
NY
01
—
X97331
BC/BS
—
Enumeration date
02/27/2017
Last updated
02/27/2017
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