Healthcare Provider Details

I. General information

NPI: 1851449284
Provider Name (Legal Business Name): JAN MARIE GUFFEY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3266 BROAD ST STE 1
PORT HENRY NY
12974-1176
US

IV. Provider business mailing address

97 DUDLEY RD
WESTPORT NY
12993-1702
US

V. Phone/Fax

Practice location:
  • Phone: 518-546-3100
  • Fax: 518-546-3101
Mailing address:
  • Phone: 518-962-4044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number011348
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: