Healthcare Provider Details

I. General information

NPI: 1225163553
Provider Name (Legal Business Name): DOROTHY S RUPLEY DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1722 LAKE RD SUITE 4
HAMLIN NY
14464-9590
US

IV. Provider business mailing address

8054 NEWCO DR
HAMLIN NY
14464-9727
US

V. Phone/Fax

Practice location:
  • Phone: 585-964-7790
  • Fax:
Mailing address:
  • Phone: 585-704-4419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberC03861-4B
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: