Provider Demographics
NPI:1982996336
Name:WOROB CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:WOROB CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMMITAI
Authorized Official - Middle Name:
Authorized Official - Last Name:WOROB
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:607-288-2205
Mailing Address - Street 1:1212 TRUMANSBURG RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1314
Mailing Address - Country:US
Mailing Address - Phone:607-288-2205
Mailing Address - Fax:607-793-9464
Practice Address - Street 1:1212 TRUMANSBURG RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1314
Practice Address - Country:US
Practice Address - Phone:607-288-2205
Practice Address - Fax:607-793-9464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011697111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty