=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306181862
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MATTHEW WILLIAM TOPOR D.C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/10/2012
-----------------------------------------------------
Last Update Date | 12/10/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1687 ENGLISH RD
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14616-1692
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-227-7720
-----------------------------------------------------
Fax | 585-227-7858
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1687 ENGLISH RD
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14616-1692
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-227-7720
-----------------------------------------------------
Fax | 585-227-7858
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 012265
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------