Provider Demographics
NPI:1144843699
Name:MOUNT KISCO PHYSICAL THERAPY & CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:MOUNT KISCO PHYSICAL THERAPY & CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:914-523-2878
Mailing Address - Street 1:103 S BEDFORD RD STE 109
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3452
Mailing Address - Country:US
Mailing Address - Phone:914-241-8000
Mailing Address - Fax:914-241-3547
Practice Address - Street 1:103 S BEDFORD RD STE 109
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3452
Practice Address - Country:US
Practice Address - Phone:914-241-8000
Practice Address - Fax:914-241-3547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty