Organization
FLEETWOOD CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT ALAN RUSSELL JR. D.C. (PRESIDENT)
(914) 699-6770
Entity
Organization
Contact information
Practice address
25 E BROAD ST, MOUNT VERNON, NY 10552-2207
(914) 699-6770
(914) 664-0090
Mailing address
25 E BROAD ST, MOUNT VERNON, NY 10552-2207
(914) 699-6770
(914) 664-0090
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X002707C-1
NY
111N00000X
Chiropractor
X004166-1
NY
Other
Enumeration date
08/31/2007
Last updated
08/31/2007
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