Provider Demographics
NPI:1689011827
Name:JM CHIROPRACTIC PC
Entity Type:Organization
Organization Name:JM CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-852-3176
Mailing Address - Street 1:130 N CARLL AVE
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-2238
Mailing Address - Country:US
Mailing Address - Phone:631-482-8829
Mailing Address - Fax:631-482-8827
Practice Address - Street 1:130 N CARLL AVE
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2238
Practice Address - Country:US
Practice Address - Phone:631-482-8829
Practice Address - Fax:631-482-8827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008298-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty