Organization
COMPLETE CHIROPRACTIC REABILITATION OF PORT JEFFERSON STATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD TANZA JR. DC (PRESIDENT)
(631) 642-2388
Entity
Organization
Contact information
Practice address
671 OLD TOWN RD, PORT JEFFERSON STATION, NY 11776-4200
(631) 642-2388
Mailing address
PO BOX 66, MOUNT SINAI, NY 11766-0066
(631) 642-2388
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
NY
Other
Enumeration date
03/02/2007
Last updated
08/22/2020
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