Provider Demographics
NPI:1003281601
Name:SPINEBODYSOUL CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:SPINEBODYSOUL CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOHNE'
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:212-344-1700
Mailing Address - Street 1:111 JOHN ST
Mailing Address - Street 2:SUITE 1622
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-3101
Mailing Address - Country:US
Mailing Address - Phone:212-344-1700
Mailing Address - Fax:
Practice Address - Street 1:111 JOHN ST
Practice Address - Street 2:SUITE 1622
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-3101
Practice Address - Country:US
Practice Address - Phone:212-344-1700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty