Organization
ISLAND CHIROPRACTIC WELLNESS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN MICHAEL GERVASIO D.C., M.S. (OWNER)
(516) 541-8933
Entity
Organization
Contact information
Practice address
5500 MERRICK RD, MASSAPEQUA, NY 11758-6231
(516) 541-8933
Mailing address
5500 MERRICK RD, MASSAPEQUA, NY 11758-6231
(516) 541-8933
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
X011710-1
NY
Other
Enumeration date
08/18/2009
Last updated
08/18/2009
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