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General NPI Number Information
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NPI Number | 1285926782
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Entity Type | Organization
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Legal Business Name | CHIRO ONE WELLNESS P. C.
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Dates
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Enumeration Date | 05/03/2011
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Last Update Date | 03/02/2016
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Provider Practice Location Address
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Address Line | 4214 CLINTON ST
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City | WEST SENECA
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State | NY
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Zip | 14224-4910
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Country | US
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Telephone | 716-903-0008
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Fax |
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Provider Business Mailing Address
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Address Line | 4214 CLINTON ST
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City | WEST SENECA
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State | NY
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Zip | 14224-1606
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Country | US
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Telephone | 716-903-0008
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MOHAMED JAMIL MUNASSAR
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Credential | D.C.
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Telephone | 716-903-0008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | XO119081
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License Number State | NY
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