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General NPI Number Information
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NPI Number | 1669870796
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Entity Type | Organization
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Legal Business Name | DR. STEPHANIE PAUTLER-BEA, D.C., P.C.
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Dates
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Enumeration Date | 12/04/2014
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Last Update Date | 03/05/2015
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Provider Practice Location Address
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Address Line | 13305 BROADWAY ST
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City | ALDEN
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State | NY
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Zip | 14004-1324
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Country | US
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Telephone | 716-902-5261
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Fax | 716-902-4303
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Provider Business Mailing Address
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Address Line | 13305 BROADWAY ST
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City | ALDEN
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State | NY
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Zip | 14004-1324
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Country | US
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Telephone | 716-902-5261
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Fax | 716-902-4303
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Authorized Official
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Title or Position | PRESIDENT/CHIROPRACTOR
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Name | DR. STEPHANIE ROSE PAUTLER-BEA
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Credential | D.C.
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Telephone | 716-902-5261
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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 | 011323
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License Number State | NY
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