Provider Demographics
NPI:1528348299
Name:STORMS FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:STORMS FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:STORMS
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:607-936-4954
Mailing Address - Street 1:352 E 1ST ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-2926
Mailing Address - Country:US
Mailing Address - Phone:607-936-4954
Mailing Address - Fax:607-936-2480
Practice Address - Street 1:352 E 1ST ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2926
Practice Address - Country:US
Practice Address - Phone:607-936-4954
Practice Address - Fax:607-936-2480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX3280111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT26577Medicare UPIN
NY55977AMedicare PIN