Healthcare Provider Details

I. General information

NPI: 1205776630
Provider Name (Legal Business Name): DEBOLE CHIROPRACTIC WEBSTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 NORTH AVE
WEBSTER NY
14580-3009
US

IV. Provider business mailing address

71 NORTH AVE
WEBSTER NY
14580-3009
US

V. Phone/Fax

Practice location:
  • Phone: 585-301-6563
  • Fax: 585-398-8044
Mailing address:
  • Phone: 585-301-6563
  • Fax: 585-398-8044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: SCOTT SHALES
Title or Position: OWNER
Credential: DC
Phone: 585-301-6563