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General NPI Number Information
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NPI Number | 1518625425
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Entity Type | Organization
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Legal Business Name | TONAWANDA CHIROPRACTIC, P.L.L.C.
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Dates
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Enumeration Date | 12/08/2021
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 1201 COLVIN BLVD STE 2A
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City | BUFFALO
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State | NY
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Zip | 14223-1936
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Country | US
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Telephone | 716-490-0210
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Fax | 716-954-0208
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Provider Business Mailing Address
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Address Line | 1201 COLVIN BLVD STE 2A
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City | BUFFALO
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State | NY
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Zip | 14223-1936
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Country | US
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Telephone | 716-490-0210
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Fax | 716-954-0208
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Authorized Official
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Title or Position | OWNER
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Name | JOSHUA JOHN NELSON
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Credential | DC
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Telephone | 716-490-0210
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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 |
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License Number State |
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