Provider Demographics
NPI:1174807200
Name:COTTER, BENJAMIN ROSS (DC)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:ROSS
Last Name:COTTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 SOUTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-3211
Mailing Address - Country:US
Mailing Address - Phone:607-433-9661
Mailing Address - Fax:
Practice Address - Street 1:531 SOUTHSIDE DR
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-3211
Practice Address - Country:US
Practice Address - Phone:604-433-9661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3658111N00000X
NYX012858111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor