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General NPI Number Information
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NPI Number | 1194310730
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Entity Type | Individual
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Provider Name | ROBERT HALLICK DC
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Gender | Male
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Dates
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Enumeration Date | 03/05/2021
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Last Update Date | 03/05/2021
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Provider Practice Location Address
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Address Line | 38 ELM ST
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City | EAST AURORA
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State | NY
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Zip | 14052-2543
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Country | US
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Telephone | 716-946-9642
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Fax |
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Provider Business Mailing Address
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Address Line | 5400 E CREEK RD
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City | SOUTH WALES
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State | NY
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Zip | 14139-9761
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Country | US
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Telephone | 716-946-9642
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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 | 008756
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License Number State | NY
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