Provider Demographics
NPI:1720041346
Name:SPRING VALLEY CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:SPRING VALLEY CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BONNETT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:845-426-3701
Mailing Address - Street 1:256 OLD NYACK TPKE
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5741
Mailing Address - Country:US
Mailing Address - Phone:845-426-3701
Mailing Address - Fax:845-426-3702
Practice Address - Street 1:256 OLD NYACK TPKE
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5741
Practice Address - Country:US
Practice Address - Phone:845-426-3701
Practice Address - Fax:845-426-3702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherFEDERAL TAX ID