Provider Demographics
NPI:1760899546
Name:ATLANTIC CHIROPRACTIC INJURY CARE, PLLC
Entity Type:Organization
Organization Name:ATLANTIC CHIROPRACTIC INJURY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-523-2878
Mailing Address - Street 1:23 BRIDLE WAY
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564-2220
Mailing Address - Country:US
Mailing Address - Phone:914-523-2878
Mailing Address - Fax:
Practice Address - Street 1:23 BRIDLE WAY
Practice Address - Street 2:
Practice Address - City:PAWLING
Practice Address - State:NY
Practice Address - Zip Code:12564-2220
Practice Address - Country:US
Practice Address - Phone:914-523-2878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010917-1111N00000X
NY021858-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty