Provider Demographics
NPI:1659560506
Name:BETTIOL CHIROPRACTIC & ALTERNATIVE THERAPIES, LLP
Entity Type:Organization
Organization Name:BETTIOL CHIROPRACTIC & ALTERNATIVE THERAPIES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARYN
Authorized Official - Middle Name:EVERETT
Authorized Official - Last Name:SELTZER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:607-433-1150
Mailing Address - Street 1:427 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-1928
Mailing Address - Country:US
Mailing Address - Phone:607-433-1150
Mailing Address - Fax:607-433-5298
Practice Address - Street 1:427 MAIN ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-1928
Practice Address - Country:US
Practice Address - Phone:607-433-1150
Practice Address - Fax:607-433-5298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2011-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWYPXW1Medicare PIN
NYBA1331Medicare PIN