Healthcare Provider Details

I. General information

NPI: 1649593229
Provider Name (Legal Business Name): LIFECARE CHIROPRACTIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2010
Last Update Date: 03/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4446 MAIN ST SUITE 100
SNYDER NY
14226-4406
US

IV. Provider business mailing address

4446 MAIN ST SUITE 100
SNYDER NY
14226-4406
US

V. Phone/Fax

Practice location:
  • Phone: 716-839-0047
  • Fax:
Mailing address:
  • Phone: 716-839-0047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX008438-1
License Number StateNY

VIII. Authorized Official

Name: DR. THOMAS M FRANK
Title or Position: PRESIDENT
Credential: D.C.
Phone: 716-839-0047