A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal...
ID license #CHIA 1163taxonomy 111N00000X
Identifiers
Type
Value
Notes
01 (ID)
1369151
MEDICARE GROUP #
01 (ID)
C9672
BLUE CROSS GROUP #
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
Legacy Health Partners
Type code 3recorded 2018-12-07
Practice context
Single-site organization. Only one practice location on file.
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