Healthcare Provider Details

I. General information

NPI: 1205890472
Provider Name (Legal Business Name): LORRAINE ANN KOCHANOWSKI-SUTTER DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 11/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4974 TRANSIT RD
DEPEW NY
14043-4616
US

IV. Provider business mailing address

2247 HOPKINS RD
GETZVILLE NY
14068-1436
US

V. Phone/Fax

Practice location:
  • Phone: 716-685-9631
  • Fax:
Mailing address:
  • Phone: 716-639-0206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX009061
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: