Provider Demographics
NPI:1871663575
Name:MILLBROOK FAMILY CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:MILLBROOK FAMILY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ST. GERMAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-677-3425
Mailing Address - Street 1:80 ROUTE 343
Mailing Address - Street 2:
Mailing Address - City:MILLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:12545-6163
Mailing Address - Country:US
Mailing Address - Phone:845-677-3425
Mailing Address - Fax:845-677-5296
Practice Address - Street 1:80 ROUTE 343
Practice Address - Street 2:
Practice Address - City:MILLBROOK
Practice Address - State:NY
Practice Address - Zip Code:12545-6163
Practice Address - Country:US
Practice Address - Phone:845-677-3425
Practice Address - Fax:845-677-5296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY XOO9434111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty