Provider Demographics
NPI:1346463643
Name:CHATHAM CHIROPRACTIC & WELLNESS PC
Entity Type:Organization
Organization Name:CHATHAM CHIROPRACTIC & WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEURY
Authorized Official - Suffix:
Authorized Official - Credentials:CH
Authorized Official - Phone:518-392-2300
Mailing Address - Street 1:19 HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12037-1110
Mailing Address - Country:US
Mailing Address - Phone:518-392-2300
Mailing Address - Fax:518-392-8581
Practice Address - Street 1:19 HUDSON AVE
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NY
Practice Address - Zip Code:12037-1110
Practice Address - Country:US
Practice Address - Phone:518-392-2300
Practice Address - Fax:518-392-8581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
XFWNF1Medicare PIN