Provider Demographics
NPI:1932856366
Name:QC CHIROPRACTIC AND PHYSICAL THERAPY
Entity type:Organization
Organization Name:QC CHIROPRACTIC AND PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:QUEENIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LADAO-SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, PT
Authorized Official - Phone:917-444-6235
Mailing Address - Street 1:PO BOX 40438
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-0438
Mailing Address - Country:US
Mailing Address - Phone:917-444-6235
Mailing Address - Fax:
Practice Address - Street 1:9205 ROCKAWAY BLVD
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11417-2428
Practice Address - Country:US
Practice Address - Phone:347-475-0078
Practice Address - Fax:347-480-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-06
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty