| Back On Track Chiropractic, Llc | |
|
8129 Brewerton Rd, Cicero, NY 13039 | |
| (315) 699-9887 | |
| Not Available |
| Full Name | Back On Track Chiropractic, Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 8129 Brewerton Rd, Cicero, New York |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366612400 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | X009391 (New York) | Primary |
| Provider Name | Kenneth A Iles |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1821015470 PECOS PAC ID: 3678732658 Enrollment ID: I20120312000108 |
| Mailing Address | Practice Location Address |
|---|---|
| Back On Track Chiropractic, Llc 8129 Brewerton Rd, Cicero, NY 13039 Ph: (315) 699-9887 | Back On Track Chiropractic, Llc 8129 Brewerton Rd, Cicero, NY 13039 Ph: (315) 699-9887 |
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