Provider Demographics
NPI:1184138133
Name:CLIMB CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:CLIMB CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DC
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOODY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:315-733-0590
Mailing Address - Street 1:421 BROAD ST STE 4
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-1210
Mailing Address - Country:US
Mailing Address - Phone:315-733-0590
Mailing Address - Fax:315-693-1141
Practice Address - Street 1:421 BROAD ST STE 4
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-1210
Practice Address - Country:US
Practice Address - Phone:315-733-0590
Practice Address - Fax:315-693-1141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-29
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013028111N00000X
111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty