Provider Demographics
NPI:1427223072
Name:EAGLE'S TOUCH CHIROPRACTIC & WELLNESS, PC
Entity Type:Organization
Organization Name:EAGLE'S TOUCH CHIROPRACTIC & WELLNESS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:EAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-385-1400
Mailing Address - Street 1:PO BOX 58
Mailing Address - Street 2:
Mailing Address - City:OLD BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11804-0058
Mailing Address - Country:US
Mailing Address - Phone:631-385-1400
Mailing Address - Fax:631-385-1400
Practice Address - Street 1:150 BROADHOLLOW RD
Practice Address - Street 2:SUITE 108
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4905
Practice Address - Country:US
Practice Address - Phone:631-385-1400
Practice Address - Fax:631-385-1400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty