Provider Demographics
NPI:1942857875
Name:WURTSBORO ACUPUNCTURE, CHIROPRACTIC AND PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:WURTSBORO ACUPUNCTURE, CHIROPRACTIC AND PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JACEK
Authorized Official - Middle Name:
Authorized Official - Last Name:KURA
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT, DC, MSA
Authorized Official - Phone:845-733-5022
Mailing Address - Street 1:PO BOX 490
Mailing Address - Street 2:
Mailing Address - City:WURTSBORO
Mailing Address - State:NY
Mailing Address - Zip Code:12790-0490
Mailing Address - Country:US
Mailing Address - Phone:845-733-5022
Mailing Address - Fax:845-733-5022
Practice Address - Street 1:80 SULLIVAN ST
Practice Address - Street 2:
Practice Address - City:WURTSBORO
Practice Address - State:NY
Practice Address - Zip Code:12790-8226
Practice Address - Country:US
Practice Address - Phone:845-733-5022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty