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General NPI Number Information
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NPI Number | 1063559953
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Entity Type | Individual
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Provider Name | DAVID EDWIN JAUCH JR. D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5555 MAIN ST
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5430
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Country | US
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Telephone | 716-631-2236
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Fax |
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Provider Business Mailing Address
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Address Line | 343 BRANTWOOD RD
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City | SNYDER
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State | NY
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Zip | 14226-4307
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Country | US
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Telephone | 716-465-5567
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 009402
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License Number State | NY
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