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General NPI Number Information
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NPI Number | 1457889784
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Entity Type | Organization
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Legal Business Name | WARCHAL CHIROPRACTIC & SPORTS REHAB PLLC
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Dates
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Enumeration Date | 05/31/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 6221 STATE ROUTE 31 STE 110B
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City | CICERO
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State | NY
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Zip | 13039-8724
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Country | US
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Telephone | 315-288-4483
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Fax | 315-288-4492
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Provider Business Mailing Address
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Address Line | 6221 STATE ROUTE 31 STE 110B
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City | CICERO
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State | NY
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Zip | 13039-8724
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Country | US
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Telephone | 315-288-4483
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Fax | 315-288-4492
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. DAVID PETER WARCHAL JR.
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Credential | DC
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Telephone | 315-725-6698
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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 | X011987-1
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License Number State | NY
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