Healthcare Provider Details

I. General information

NPI: 1255483368
Provider Name (Legal Business Name): BUCHANAN CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 08/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 E BRUNDAGE STREET
SHERIDAN WY
82801-6353
US

IV. Provider business mailing address

50 E BRUNDAGE ST
SHERIDAN WY
82801-6353
US

V. Phone/Fax

Practice location:
  • Phone: 307-673-1222
  • Fax:
Mailing address:
  • Phone: 307-673-1222
  • Fax: 307-673-1223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number587
License Number StateWY

VIII. Authorized Official

Name: DR. JAMES CHRISTIAN BUCHANAN
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 307-673-1222