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General NPI Number Information
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NPI Number | 1053408971
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Entity Type | Organization
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Legal Business Name | RADEMACKER SPECIFIC CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 23 NORTH ST SUITE 7
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City | CANANDAIGUA
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State | NY
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Zip | 14424-1053
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Country | US
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Telephone | 585-394-8430
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Fax | 585-394-8154
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Provider Business Mailing Address
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Address Line | 23 NORTH ST SUITE 7
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City | CANANDAIGUA
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State | NY
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Zip | 14424-1053
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Country | US
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Telephone | 585-394-8430
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Fax | 585-394-8154
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. BREE RADEMACKER
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Credential | D.C.
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Telephone | 585-394-8430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X010717-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X010716-1
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License Number State | NY
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